Manish Khaitan

Biliopancreatic Diversion Surgery

Biliopancreatic Diversion, or BPD, is a surgical procedure used in the treatment of obesity. In BPD surgery, the lower two-thirds portion of the stomach is removed. The remaining stomach is attached to the distal segment of the small intestine, the ilium. By bypassing the first two segments of the small intestine, the duodenum and jejunum, the small intestine is shortened therefore nutrient absorption is significantly reduced leading to weight loss.

Advantages of Biliopancreatic Diversion Surgery include:

  • Best weight loss results of all surgeries
  • Eating capacity is greater than other surgeries
  • Continued weight loss for 18-24 months post-surgery
  • Many patients maintain a weight loss of 75-80% of excess weight 10 years post-op
  • Adjustable and partially reversible but only with additional surgery
  • Good option for revision if other techniques have failed
  • Improved health problems associated with severe obesity (i.e. Diabetes, high blood pressure, sleep apnoea, etc.) Improved mobility and quality of life

Disadvantages of Biliopancreatic Diversion Surgery include:

  • Most complicated of currently available obesity surgeries
  • Usually performed as open operation instead of Laparoscopically, with associated risks
  • Risk of death 1:200 surgeries
  • Longer recovery time, usually 6-8 weeks
  • Mal absorptions require lifelong supplementation of fat soluble vitamins (A, D, E, and K), B12, calcium and iron.
  • Requires permanent lifelong changes to patient’s diet and lifestyle. Risk of iron deficiency anaemia and osteoporosis if supplements not taken
  • Requires gallbladder removal during surgery due to high risk of gallstones
  • Dumping syndrome: nausea, reflux, diarrhoea can occur after ingesting high sugar foods
  • Increased stool frequency to 2-4/day Foul flatulence and diarrhoea if fatty foods eaten

Risks & Complications

  • As with any surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages.
  • It is important that you are informed of these risks before the surgery takes place.

Most patients do not have complications after Biliopancreatic Diversion surgery; however complications can occur and depend on the patient’s health status.

Complications can be medical (general) or specific to BPD.

Medical complications include those of the anaesthesia and your general wellbeing. Almost any medical condition can occur so this list is not complete. Complications include:

  • Allergic reaction to medications
  • Blood loss requiring transfusion with its low risk of disease transmission
  • Heart attack, strokes, kidney failure, pneumonia, bladder infections
  • Complications from anaesthesia
  • Serious medical problems can lead to on-going health concerns, prolonged hospitalization, or rarely death. (less than 1% cases)

Specific complications for BPD include:

  • DVT (blood clot in the deep leg veins)
  • Damage to adjacent organs
  • Leakage of digestive contents can lead to serious infection
  • Stricture (narrowing) of the opening between the stomach and small intestine
  • Dumping Syndrome: Vomiting, reflux, and diarrhoea caused by stomach contents moving too rapidly through the small intestine
  • Abdominal hernias
  • Bleeding ulcers
  • Kidney Stones

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The results of the treatments may vary from person to person and its not a typical result common to all.