Duodenal Switch in India
What is Duodenal Switch ?
The duodenal switch (DS) procedure, also known as biliopancreatic diversion with duodenal switch (BPD-DS) or gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect.
The restrictive portion of the surgery involves removing approximately 70% of the stomach along the greater curvature.
The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel.
The primary advantage of duodenal switch (DS) surgery is that its combination of moderate intake restriction with substantial calorie malabsorption results in a higher percentage of excess weight loss versus a purely restrictive gastric bypass for all individuals In a Systemic Meta Analysis of the weight loss surgical procedures Buckwald et.al. Type 2 diabetics have had a 98% "cure"(i.e. became euglycemic) almost immediately following surgery which is due to the metabolic effect from the intestine switch.
The malabsorptive element of the DS requires that those who undergo the procedure take vitamin and mineral supplements above and beyond that of the normal population, as do patients having the RNY surgery. Commonly prescribed supplements include a daily multivitamin, calcium citrate, and the fat-soluble vitamins A, D, E and k.
All surgical procedures involve a degree of risk however this must be balanced against the significant risks associated with severe obesity.
Some of the surgical risks or complications for this procedure are: perforation involving small bowel, duodenum, or stomach causing a leak, infection, abscess, deep vein thrombosis (blood clot), and pulmonary emboli (blood clot traveling to the lungs).
Longer term risks include the possibility of vitamin and mineral deficiency, hernia and bowel obstruction. There is little information as to the longer-term risks (greater than 15 year), as this procedure was very rarely performed prior to the year 2000.
Malnutrition is an uncommon and preventable risk after duodenal switch.