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Confusion Regarding Duodenal Switch

They are still performing “that” operation?
Why doesn't everyone know about Duodenal Switch?


When patients tell their doctor they want to have the Duodenal Switch procedure, many PCPs have never heard of it and assume it is an older procedure that is no longer performed. When the phrase, "THAT operation" is used it sometimes refers to the Jejunoileal Bypass (JIB) or the Biliopancreatic Diversion (BPD) procedure.(More information regarding JIB and BPD can be found in the History section of Duodenal Switch.) Some doctors are not aware of the Duodenal Switch procedure and how it reduces or resolves some of the complications that could occur following the JIB or BPD procedures.

The Duodenal Switch operation evolved from BPD and was used to minimize the complications of BPD while maximizing the effect of preserving the pyloric valve as a regulatory mechanism for gastric emptying to avoid the complications of the dumping syndrome, and the marginal ulcers. BPD and DS are as similar as RNY (Roux En-Y, Gastric Bypass) and DS. Both procedures involved the stomach and the small bowel in varying sizes; this is the only similarity between the procedures. The anatomy and the physiology of these three procedures are very different. It is very important that any patient considering any weight loss surgery is clear about the differences of the mentioned weight loss procedures. Be advised that the procedures are called for what they are and DS cannot be classified as a gastric bypass “type” procedure.

Gary J. Anthone, MD, FACS, "The Duodenal Switch Operation for Morbid Obesity", Aug 2005, pg 829-830. [9]

The duodenal switch operation includes a restrictive and malabsorptive component. This has resulted in conflicting opinions regarding the side effects of the malabsorptive component; some investigators believe that severe metabolic and nutritional complications are frequent after the operation. This likely is due to a presumed similarity of the currently performed malabsorptive operations (ie. biliopancreatic diversion and duodenal switch) to the old and now-discredited jejunoileal bypass (JIB). Unlike the jejunoileal bypass, the duodenal switch does not have a blind enteric limb.

Gary J. Anthone, MD, FACS, "The Duodenal Switch Operation for Morbid Obesity", Aug 2005, pg 820-821. [9]

 


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