Biliopancreatic Diversion with a Duodenal Switch
Abstract
Background This paper evaluates biliopancreatic diversion combined with the duodenal switch, forming a hybrid procedure which is a combination of restriction and malabsorption. Methods The evaluation is of the first 440 patients undergoing this procedure who had had no previous bariatric surgery. The mean starting weight was 183 kg, with 41% of our patients considered super morbidly obese (BMI > 50). Results There was an average maximum weight loss of 80% excess weight by 24 months postoperation; this continued at a 70% level for 8 years. Major complications were found in almost 9% of the cases. There were two perioperative deaths, one from pulmonary embolism and one from acute pulmonary obstruction. There were 36 type II diabetics, all of whom have discontinued medication following the surgery. Seventeen revisions were performed to correct excess weight loss and low protein levels. There have been no marginal ulcers, no cases of dumping syndrome, no foreign material used, and the procedure is a pyloric saving procedure which is functionally reversible. Conclusions This operation has vastly improved the lives of seriously obese patients with many comorbidities. All type II diabetics have essentially been cured of their disease. The procedure was tolerated well and patients are quite satisfied. There was minimal regain of weight with this method.
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BPD-DS has shown profound therapeutic effects on MASLD in patients with severe obesity.
“It is a combined restrictive and malabsorptive bariatric procedure and has shown profound therapeutic effects on metabolic dysfunction-associated steatotic liver disease in patients with severe obesity [35].”
From Impact of Bariatric Surgery and Endoscopic Therapies on Liver Health in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review (2025) · cites this paper as [35]
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- Authors
- Hess, D. S., & Hess, D. W.
- Venue
- Obesity Surgery
- Published
- 1998-06-01
- Volume
- 8
- Issue
- 3
- Pages
- 267-282
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2013050940
- Cited by
- 1,040
- References
- 0
- Citations by year
- 2026: 21 · 2025: 31 · 2024: 31 · 2023: 46 · 2022: 35 · 2021: 48 · 2020: 29 · 2019: 33 · 2018: 42 · 2017: 30 · 2016: 57 · 2015: 47 · 2014: 55 · 2013: 43 · 2012: 68
- FWCI
- 5.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- biliopancreatic diversion, duodenal switch
- MeSH terms
- Adult, Diabetes Mellitus, Diabetes Mellitus, Type 2, Duodenum, Female, Follow-Up Studies, Humans, Male, Obesity, Obesity, Morbid, Postoperative Complications, Reoperation, Time Factors, Weight Loss, Comorbidity, Biliopancreatic Diversion
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