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Biliopancreatic Diversion: Procedure, Recovery, Cost, Risk & Complication

What is Biliopancreatic Diversion?

Biliopancreatic diversion surgery is a type of gastric bypass surgery that is not commonly performed on people, as it is more complicated and risky than the other gastric bypass procedures. A biliopancreatic diversion changes the normal process of digestion and allows food to bypass part of the small intestine which enables your body to absorb fewer calories. A common channel remains in which bile mixes with other pancreatic digestive juices before entering the colon. During surgery, a large portion of the stomach is cut out and removed to create a smaller stomach pouch, and then a part of the digestive system is re-routed so that food can bypass part of the small intestine. There are two types of biliopancreatic diversion surgeries: a biliopancreatic diversion and a biliopancreatic diversion with duodenal switch.


Because of the risks, this surgery is for people who are more than severely obese with a BMI of 50 or higher. It is done on people who want to lose weight but haven't been able to any other way - diet, exercise or medicine and this is creating serious health problems for them. In addition, biliopancreatic diversion patients should be prepared to make the necessary lifestyle changes that are required of bariatric surgery patients. This includes a commitment to a healthy lifestyle.

What Procedure is followed :

Pre Procedure

This surgery is a lot more complicated than other gastric bypass surgeries. There are a few pre-procedures you need to follow to ensure you are prepared for the actual surgery :

  • Inform your doctor about all medications and natural health products you take. Follow his instructions on whether or not to continue taking these medications before surgery.
  • If you take any blood thinners like clopidrogel, warfarin or aspirin be sure to talk to your doctor about continuing to take these medicines before surgery .
  • You will be asked to take a bath before surgery but not to apply any lotions, deodrants, perfumes or nail polish. Also you should not wear any jewellery, piercings or contact lenses.
  • You may be asked to follow a complete liquid diet for several days before the surgery. Follow your doctor’s instructions.

During Procedure

At the time of surgery, the area of surgery is often marked to avoid any errors. You will be administered with anaesthesia and will be asleep during the during the procedure. During the surgery a part of stomach will be cut out and removed. The remaining half will be connected to the lower portion of the small intestine. In the biliopancreatic diversion surgery with duodenal switch, an entirely different part of the stomach gets removed and the doctor leaves the pylorus intact. The pylorus is a valve that controls and coordinates food drainage from the stomach. These are done by making a large cut in the belly or by making a small cut and using small tools and a camera to guide the surgery.

Post Procedure

You may need to stay in the hospital for 1 or more days after the surgery. The doctor will close the incision in your belly with staples or stitches. These will be removed 7 to 10 days after surgery, unless your doctor uses stitches that can dissolve. The incision will leave a scar that fades with time. You may take 3 to 5 weeks before you can get back to your usual routine. You will be given more specific instructions about your diet, exercise, and recovering from your surgery by your doctor.

Risk & Complication

There are many risks and complications involved with biliopancreatic diversion surgery including dumping syndrome, diarrhoea, nausea, shakiness, faintness, deficiency of iron, calcium, magnesium or vitamin b12, infection, stomach leakage into the abdominal cavity, peritonitis, deep being thrombosis, pulmonary embolism, gallstones, anaemia, osteoporosis, irregular bowel movements, and constipation. After the surgery you have to be careful about your diet. Your body will have difficulty in absorbing nutrients so you will have to reply on vitamin and mineral supplements.

More Info

Depending on how the surgery was done, you'll have to watch your activity during recovery. If you have had open surgery, avoid lifting heavy weights or doing strenuous exercise. In this case, you will probably be able to return to your normal routine in 4 to 6 weeks.

Your doctor will give you specific instructions about what to eat after the surgery. For about the first month after surgery, you should only consume amounts of soft foods and liquids while you are healing. It is important to try to sip water throughout the day to avoid dehydration.

Biliopancreatic diversion surgery typically ranges from $15,000 to $25,000. People who have this surgery must take vitamin and mineral supplements for the rest of their lives, which can be expensive.

Popular Health Tips

Duodenal Switch With Biliopancreatic Diversion - Know More About This Surgery!

Bariatrician, Bangalore
Duodenal Switch With Biliopancreatic Diversion - Know More About This Surgery!

A biliopancreatic diversion with duodenal switch is a less common kind of weight-loss procedure. The procedure is conducted in two steps. The first step involves sleeve gastrectomy, where about 80 percent of the stomach gets removed, hence leaving behind a small stomach, in the shape of a tube. Though the valve, which releases food to the small intestine remains intact along with a small portion of the small intestine that normally stays connected to the stomach. The second step ensures that the major part of the intestine gets bypassed through connecting the end portion of the intestine to the duodenum close to the stomach. A Biliopancreatic Diversion (BPD) puts a limit on how much one can eat and thus reduces the nutrients from getting absorbed, which includes fats and proteins.

BPD is usually conducted as a single procedure but in some selective situations, the procedure might get performed as two separate operations, sleeve gastrectomy and that is followed by intestinal bypass once the process of losing weight has begun.

Why the surgery is conducted?
A Duodenal Switch with Biliopancreatic Diversion is done in order to assist a person in losing excess weight and thus reduce the risk of developing potential life-threatening health problems related to health, which includes:

Eligible candidates for the surgery

  • This surgery is mostly done only when people have tried to lose weight by making improvements in their diet and exercise habits.
  • Still, this surgery is not for every individual who is overweight. People would have to go through an extensive process of screening to determine if they qualify.
  • Patients, who become eligible, have to be willing to make permanent changes so as to lead a healthy lifestyle both before as well as after the surgery.
  • This might include long-term plans where they follow-up by monitoring if they are maintaining their nutrition, lifestyle, behaviour and also their medical conditions.

Risks associated with the surgery
This particular surgery, as with any other surgery, carries some potential risks. They are both in the short-term and in the long-term.

Risks associated with BPD/DS are similar to any abdominal surgery and include:

3304 people found this helpful

Bariatric Weight Loss Surgery - How Laparoscopy Can Help In It?

MBBS, MS - General Surgery, FRCS - General Surgery , Fellowship in Minimal Access Surgery
General Surgeon, Delhi
Bariatric Weight Loss Surgery - How Laparoscopy Can Help In It?

Obesity is a serious lifestyle disorder that can trigger a myriad of health complications. You may often come across people who fail to lose an inch even after toiling hard. The situation may be further complicated and life-threatening if a person is suffering from diabetes, hypertension, arthritis or a heart problem. Bariatric Surgery comes as a much-needed relief for people who desperately need to lose weight to prevent health problems. People between 18-65 years of age can go for a Bariatric weight loss surgery. The surgery is also helpful for people with morbid obesity (a condition where the BMI is over 40) with associated complications.

Common types of Bariatric surgeries

  1. The Laparoscopic Gastric Banding: The gastric banding surgery is a surgical weight loss procedure that divides the stomach into two compartments so that a person consumes lesser amount of food.
    • The surgery requires the surgeon to make 3-4 small cuts in the belly.
    • An adjustable silicone band is placed into the stomach (through the small incisions) to divide the stomach into two compartments (a smaller upper half and a bigger lower part).
    • Due to the banding, the stomach can hold not more than an ounce of food, thus limiting the amount of food a person can eat.
    • There is an opening in the band which serves as a passage through which the food eaten is passed to the rest of the stomach.
    • There is a plastic tube that connects the band to an injection port (situated under the skin). It is through this port that saline is either added or removed from the silicone band (to adjust the tightness of the band).
  2. Roux-en-Y Gastric Bypass Surgery (RGB): The bypass surgery also involves compartmentalizing the stomach into an upper half (small pouch, almost the size of a walnut) and a bigger lower part. Like the gastric banding, the rearrangement reduces the amount of food the stomach can hold to a great extent. In the next step, also termed as the bypass step, the surgeon makes a small hole in the pouch to connect it to the small intestine or the jejunum. As a result of the bypass, the food will now directly enter the small intestine from the pouch. While the bypass surgery can be done using laparoscopy, a person can also undergo an open surgery.
  3. Laparoscopic Sleeve Gastrectomy: As the name suggests, the surgery involves excision of a large part of a stomach. The excision leaves behind a small sleeve-like pouch, the arrangement ensuring that a person consumes a lesser amount of food.
  4. Biliopancreatic Diversion: The surgery is risky and is advised only when an individual has a BMI of more than 50. In Biliopancreatic Diversion, the surgeon excises a part of the stomach, while connecting the remaining half to the lower part of the small intestine or jejunum. As a result, a person consumes lesser calories than before. In case you have a concern or query you can always consult an expert & get answers to your questions!
2127 people found this helpful

Bariatric Surgery - Know Forms Of It!

MBBS, MS - General Surgery
Bariatrician, Mumbai
Bariatric Surgery - Know Forms Of It!

Bariatric surgery is a procedure that involves modifications to the digestive system to restrict calorie intake or nutrient absorption by the body. These surgeries are usually recommended when lifestyle changes like exercise and diet may not cause the desired weight loss. In most such patients bariatric surgery can help lose 60% -100% excess weight within 1 year.

The various types of surgeries that come under this category are -

1. Gastric bypass – A common bariatric surgery, gastric bypass works through alteration of stomach size and re-routing of small intestine in a way that it leads to reduced consumption of calories. This procedure also causes alterations in the behavior of the gut hormones resulting in appetite reduction.

2. Sleeve gastrectomy – Commonest bariatric surgery, in this procedure almost 80% of the stomach area is removed surgically, which cause an overall reduction in the amount of calories consumed. This results in modification of gut hormones and altered gut bacteria linked with reduced appetite.

4. Biliopancreatic Diversion with Duodenal Switch - This procedure involves surgical removal of a large area of the stomach along with bypassing a major portion of the smaller intestine. This procedure may reduce fat absorption of up to 70%. The behavior of the gut hormones change resulting in a decrease in appetite and improved satiety.

3094 people found this helpful

Weight Loss Surgery - Know Its Types!

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
General Surgeon, Hyderabad
Weight Loss Surgery - Know Its Types!

Weight loss surgery or bariatric surgery helps lose weight in those people who are about 100 pounds (male) and 80 pounds (female). It helps individual resolve obesity-related medical problems.

Types of Weight Loss Surgeries-

1. Gastric Band

A band is put around stomach tightly which divides the stomach into two sections, namely smaller upper and larger lower which is connected through a small tube by which emptying of the upper part becomes slow. Since less food is required to fill this pouch; there is no need to eat much. The band is connected to a device under the skin. It can be tightened after 4-6 weeks after surgery.

Merits: Simpler method. Recovery is faster leaving a small scar.

Demerits: Lesser weight loss than other surgeries. The band might slip out. Vomiting can occur after overeating food quickly.

2. Sleeve Gastrectomy

In this procedure, a larger portion of the stomach is cut off, and the remaining smaller part is attached to the intestine. Smaller the stomach, lesser is the production of appetite-regulating hormone ghrelin. As a result, less food is taken in.

Merits: It is a simple method. As it does not involve intestines, the process of absorption takes place smoothly, and the patient does not fall short of nutrients.

Demerits: It is an irreversible process. It can cause infection and leaking of sleeve might take place.

3. Duodenal Switch with Biliopancreatic Diversion

In this procedure, a larger part (70%) of the stomach is cut off leaving the duodenum. The surgeon cuts the middle part of intestine attaches it to the duodenum. It is called duodenal switch. The leftover part of the intestine is again attached to the last part of intestine allowing pancreatic juices and bile to flow into that part. This is biliopancreatic division. Food passes directly into the small intestine limiting absorption of nutrients and calories, ultimately resulting in weight loss.

Merits: It is a fast method to lose weight, and the patient can eat large amounts of food.

Demerits: Nutritional deficiencies are seen.

4. Gastric Ballooning

A small balloon filled with salt and water is placed in the stomach through a thin tube via throat.Merits: The patient feels full and will not be able to eat much.

Demerits: It is a temporary method, which can last only for 6 months.

5. Gastric Bypass

In this procedure, the surgeon divides the stomach into two parts, namely upper and lower. Here, the upper part of the stomach is directly connected to the last part of the intestine.

Merits: More than 50% weight loss take place, as much weight gets reduced, and conditions, such as diabetes and blood pressure come under control.

Demerits: As less of nutrients are absorbed, the patient might land up into anemia and nutritional deficiency. The patient might need to take supplements after surgery to maintain balance. In case you have a concern or query you can always consult an expert & get answers to your questions!

3281 people found this helpful

Bariatric Surgery - Types Of Surgeries That Come Under It!

MBBS, MS - General Surgery, M.Mas, Diploma In Minimal Access Surgery, Fellowship In Minimal Access Surgery, Fellowship In Robotic Surgery, FICS, F.I.A.G.E.S, FAMASI
Surgical Gastroenterologist, Chennai
Bariatric Surgery - Types Of Surgeries That Come Under It!

Bariatric surgery is a procedure that involves modifications to the digestive system so that the food intake can be restricted or the nutrients absorbed by the body is reduced. This surgery is recommended when exercise and diet may not cause the desired results with weight loss. Bariatric surgeries is a group of surgeries that are procedure to reduce weight in the body.

The various types of surgeries that come under this category are

  1. Gastric bypass: The most common bariatric surgery, gastric bypass is a procedure used to reduce the size of the stomach pouch in the body. Once the size is reduced, it leads to reduced consumption of calories. This procedure also causes alterations in the behavior of the gut hormones resulting in appetite reduction.
  2. Adjustable Gastric band: This procedure involves placing an inflatable band around the upper stomach to make a small stomach area above the band. This causes one to feel full just after eating a small amount of food.
  3. Sleeve gastrectomy: In this procedure, almost 80% of the stomach area is removed surgically, resulting in a small stomach pouch being left. It reduces the stomach size which cause an overall reduction in the amount of calories. Modifications also occur in the behavior of the gut bacteria linked with reduced appetite.
  4. Biliopancreatic Diversion with Duodenal Switch: This procedure involves surgical removal of a large area of the stomach along with bypassing a major portion of the smaller intestine. This procedure may reduce fat absorption of up to 70%. The behavior of the gut hormones change resulting in a decrease in appetite and improved satiety.

1. May cause infections in the body
2. Clots may form in the blood
3. It can result in bowel problems
4. Ulcers can form in the stomach

In case you have a concern or query you can always consult an expert & get answers to your questions!

3516 people found this helpful

Popular Questions & Answers

It's not possible to have mind diversion before ejaculations. And what are the exercise for having long lasting sex?

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
Yes it i posible to have mind diversions before ejaculations and wht you need for that is a strong and controlled mind.You can start with KEGELS EXERCISE so a to have agood performance on bed.
3 people found this helpful

I feel alone, I want to study more as I am preparing for jee so I want to stop my mind diversion towards girls and sexual.Please tell.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology, Positive Psychiatry and Mental Health
Psychologist, Palakkad
Dear lybrate user, welcome to lybrate. The duty of your mind is to think. You cannot control your mind's thinking. Once you just leave your mind without diversion, it always ends up in negative territory. Over thinking leads to obsession, self talking and laziness. But certainly you can divert your thinking. You can make your mind to be always positive by engaging in creative activities, hobbies, games and passionate towards whatever you do. Thereby you can reduce your stress and tension also. Once you can do this, loss of proper sleep and stress also can be made normal. Anyhow, there is nothing to worry. Most of the psychological problems can be cured with scientific therapy methods. Take care.
1 person found this helpful

I am student of mechanical engineer, I'm not able to concentrate on studies, my mind diversion is full, so I can't able to study for 1 hour, and which table are good for memory power, so please suggest me.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
You are distracting from your aim. It shows weakness of your mind and nothing else. Just control your mind and think about your future. Studies is the easiest way to attain success and sometimes even glory. You will realise my words after few years. Just concentrate your mind on your studies and be focused because you will be known by your own name only after you attain heights and studies is a short cut to attain new heights. So always keep this in mind and target your goals, you will never forget. I will help you in this direction by prescribing you homoeopathic medicines----------- bacoppa monneri (wilmar schwabe india) chew 2 tab twice daily------- bren-up (allen) drink 2 spoon 3 times daily------------- bramhari pranayam daily for 15 minutes ------- report after 30 days-----------------
1 person found this helpful

Helo sir. This is praveen. I have a lot of headache due to over working in front of computer. So suggest that diversion.

DHMS (Hons.)
Homeopath, Patna
Hi, headache is out come of irregular life style, stress, anxiety & depression, sinusitis, spondiolosis, chronic diseases, meditional aggravation, bp. To get rid of headache you need to follow the natural tips. Go for meditation to reduce your stress and to call down your nerve to ease your problem. Take, plenty of water to eliminate toxins. Take, easily digestible, non irritant, simple on time. Take, homoeo medicine: @ coffea cruda 200-6 pills at bed time. @ nux vom 30-6 pills, thrice a day. Avoid, dust, alcohol, caffiene, junk food, late night sitting on computer, ensure sound sleep in d night.

I am a graduate student. I am suffering from kind of diversion condition. Could you please help me how to overcome this harassment situation so that I can live my life peacefully. I will be glad if I can get help as soon as possible. Thank you.

Sexologist, Noida
I would emphasise that I am not suggesting that homeopathy should be used as the only treatment in serious depressive illness where there are feelings of wanting to die or a risk of suicide, or in mental health problems such as bipolar disorder (manic depression), schizophrenia or severe postnatal depression.

Table of Content

What is Biliopancreatic Diversion?


What Procedure is followed :

Risk & Complication

More Info

Play video
Hello, I am Dr Vikass Khanna. I m working as a counsellor and hypnotist in Gurgaon Delhi. Today I will be talking about depression.

What is depression?

We have all been depressed sometimes in our lives. We ve all been through ups and downs.

What is clinical depression?

CD is a very vague and broad clubbing of thought patterns. But does depression have a substance, absence of a state you want to be in. Let s go to the roots of drips. You never visited the roots. The value system of our society which tells us to be someone to be happy to be kind, to be successful is the root of depression. We are always in a state of being someone, be somewhere, we have to be kind, to be more religious, be somewhere. Somewhere where one is not. There lies the conflict of what you are and what you want to be. Life is paly of polar opposites. You have expectations. You will have frustrations. They are eternally linked. If you don t know the definition of happiness there s no unhappiness. So why does one want to be in a futuristic state always, all the time, to be someone. As per the culture happiness, expecting something or the other all the time.

Now how do you manage depression?

Either pop a pill, take anti-depressants, which are 3 basically serotonin reuptake inhibitors. They inhibit the serotonin uptake. The chemicals they act till your taking them. In the brain circuits, a lot of adverse effects associated.

What is the other kind of motivation?

Diversion, meditation, which are again suppressions. This suppressing kind of thought, Will you get rid of depression by that? Can you stop struggling to be free of depression? It is your mind which tells that you re not happy. you re sad. You should be somewhere. You should be like this. The same mind tells you to be free of depression. It is a moment, a mental moment, a though moment. Both the things can bring about that change.

Can you be depression free by struggling?

To get rid of it. Or increasing the depression like falling into the trap of depression. Can u let go of this struggle? Can you revisit the roots of depression? Expectations that ideal state, you want to be in. ideal state.

For any help enquiry, you can either come through the platform of lybrate or you can contact me directly on my mobile no. I m available in Gurgaon and Delhi on appointments.

Thank you
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