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

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.

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

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

Dr. Ashish Pitale 87% (10 ratings)
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. Some of the effective bariatric surgeries for weight loss include Laparoscopic Gastric Band surgery Roux-en-Y Gastric Bypass Surgery (RGB) Laparoscopic Sleeve Gastrectomy Biliopancreatic Diversion Common types of Bariatric surgeries 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). 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. 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. 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.

Frenkel s Exrecises for Stroke

Dr. Vishwas Virmani 91% (18099 ratings)
Physiotherapist, Noida
Frenkel s Exrecises for Stroke
EXERCIES FOR THE LEGS IN LYING Flex and extend one leg by the heel sliding down a straight line on the table. Abduct and adduct hip smoothly with knee bent and heel on the table.Abduct and adduct leg with knee and hip extended by sliding the whole leg on the table.Flex and extend hip and knee with heel off the table.Flex and extend both the legs together with the heel sliding on the table. Flex one leg while extending the other.Flex and extend one leg while taking the other leg into abduction and adduction. Whether the patient slides the heels or lifts it off the bed he has to touch it to the marks indicated by the patient on the plinth. The patient may also be told to place the heel of one leg on various points of the opposite leg under the guidance of the therapist. EXERCISES FOR THE LEGS IN SITTING: One leg is stretched to slide the heel to a position indicated by a mark on the floor.The alternate leg is lifted to place the heel on the marked point.From stride sitting posture patient is asked to stand and then sit. Riseand sit with knees together. EXERCISES FOR THE LEGS IN STANDING: In stride standing weight is transferred from one foot to other.Place foot forward and backward on a straight line.Walk along a winding strip.Walk between two parallel lines Walk sideways by placing feet on the marked point.Walk and turn around.Walk and change direction to avoid obstacles. Similar exercises can be devised for the upper limb wherein the patient maybe directed to place the hand on the various points marked on the table or wallboard to improve coordination of all the movements in the upper limb. Certain diversional activities such as building with toy bricks or drawing on a blackboard, buttoning, combing, writing, typing are some of the activities that also improves the coordination.

6 Types Of Bariatric Surgery You Can Think of!

Dr. Ashish Pitale 87% (10 ratings)
MBBS, MS - General Surgery, FRCS - General Surgery , Fellowship in Minimal Access Surgery
General Surgeon, Delhi
6 Types Of Bariatric Surgery You Can Think of!
Obesity can shorten your lifespan by decades and also limit and reduce the quality of your life. Obesity cannot always be controlled by dieting and exercise and thus more complicated means such as bariatric surgery has to be employed. Types of bariatric surgery Most bariatric surgeries either limit your ability to consume food and thus make you feel fuller quickly or limit the absorption of nutrients from the food you eat. Certain surgeries use a combination of the two in varying degrees. Mentioned below are the most commonly employed forms of bariatric surgery Gastric Balloon This is a form of surgery wherein a specially made balloon is inserted into the stomach. In certain cases even two balloons are inserted into the stomach to reduce the room left for food. This causes you to have less food resulting in weight loss over a period of time. Gastric Sleeve This is a form of surgery wherein a major portion of the stomach is removed through the procedure. Also known as Vertical Sleeve Gastrectomy, the surgeon creates a pouch within the stomach which essentially becomes a connecting tube between the esophagus and the large intestine. The reduced stomach size causes fewer hunger related enzymes and hormones to be secreted, causing less hunger and also reducing your food intake capability. This results in weight loss over a period of time. Gastric Bypass Gastric bypass uses the combination of two techniques, lesser absorption of minerals as well as reduced intake capacity. In this method, a part of the stomach is rearranged akin to the gastric sleeve. However the leftover portion of the stomach is not removed as it can continue to secrete stomach acids. Because of the reduced size of the stomach, you would eat less and if you happen to over eat, it would cause dumping syndrome (quick and repeated bowel evacuation) which would deter you from eating more. Lap band surgery This is one form of surgery where the stomach is not reduced or cut but rather limited by a band that is put around it. This band constricts the stomach and causes the upper part to become smaller. Hence you would feel fuller from eating less, thus resulting in weight loss. V-bloc therapy This is a very modern approach to bariatric procedures which works in a very similar way to a pacemaker. A device is placed just under your skin and two leads or wires are connected to the vagal nerve. This nerve is responsible for sending the hunger signals to the brain from the stomach. This device acts as a block to the nerve signals and thus ensures you eat less. Duodenal switch This surgery is also known as a Biliopancreatic Diversion wherein the surgeons cut out the part of the stomach similar to a gastric sleeve surgery but also make adjustments to the pancreatic chain and the small intestine to reduce the absorption of minerals.
2140 people found this helpful

Stricture Urethra - Surgical Treatment Available For It!

Dr. Vijay Agrawal 86% (157 ratings)
MCh, MS - Urology
Urologist, Surat
Stricture Urethra - Surgical Treatment Available For It!
The tube transporting urine from the bladder out of the body is known as the urethra. Under normal circumstances, this tube is wide enough for urine to flow freely but in some cases, one or more section can get narrowed and restrict the flow of urine. This may be diagnosed as a urethral stricture. This length of this stricture can range from 1 cm to affecting the entire length of the urethra. This is caused by scar tissue or inflammation of tissue in the urethra. While this is a common condition that affects men, it is rarely seen to affect women. An enlarged prostate, exposure to STDs like gonorrhoea or chlamydia, suffering from an infection that causes urethral inflammation and irritation or having had a catheter recently inserted can increase the risk of suffering from a urethral stricture. An injury or tumour located near the urethra can also cause this condition. Hence, preventing this condition is not always a possibility. Common symptoms to look out for include: Inability to urinate Reduction in the flow of urine Increased urge to urinate frequently Pain while urinating Urinary incontinence Abdominal pain Swelling of the penis Discharge from the urethra Blood in the urine or semen Dark urine The bladder feeling gull even after urinating A physical examination and tests that measure the rate of urine flow and chemical composition of the urine can help a doctor determine a diagnosis of urethral strictures. You may also need to undergo STD tests and a cystoscopy. An X-ray may also help locate the stricture. The treatment for this condition depends on the severity of the symptoms. Non-surgical treatment for this condition involves using a dilator to widen the urethra. However, there is no guarantee the blockage will not recur at a later date. Alternatively, a permanent catheter may also be inserted. There are two forms of surgical treatment for a urethral stricture. Open urethroplasty: This involves removing the infected or scar tissue and restructuring the urethra. The results of this procedure depend on the size of the blockage. It is usually advised only in cases of long, severe strictures. Urine flow diversion: In the case of a severe blockage and damage to the bladder, the doctor may advise rerouting the flow of urine to an abdominal opening. This process involves connecting the ureters to an incision in the abdomen with the help of part of the intestines.
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How Stress Affect Your Kidney Functions?

Dr. Ravinder Singh Bhadoria 85% (10 ratings)
DNB (Nephrology), M.D ( Internal Medicine), MBBS
Nephrologist, Noida
How Stress Affect Your Kidney Functions?
Stress and uncontrolled reactions to stress can also lead to kidney damage. As kidneys are the blood filtering units of your body, your kidneys are prone to problems with blood circulation and blood vessels. High blood pressure and high blood sugar can place an additional strain or burden on your kidneys. Excessive stress can cause: 1) Increases your blood pressure: stress can give rise to hypertension, and since high blood pressure is one of the leading causes of kidney disease (apart from diabetes), stress can lead to an increase in blood pressure and have an adverse effect on your kidney function. 2) Can cause your blood sugar levels to plummet: stress can worsen your diabetes and often is the reason for uncontrolled blood sugar. 3) Increases the number of cigarettes you smoke. Can sudden high levels of stress have an effect on your kidneys? Not really, but yes it can compound over time and lead to kidney disease. For instance, if you drink less water or smoke too much due to stress, then in the long run it can lead to kidney disease. Since it is almost impossible to avoid stress altogether, it is important to learn how to manage stress. Failure to do so could lead to diseases, depression, and an unhealthy, unhappy lifestyle. If you want to avoid kidney failure, heart failure, stroke, high blood pressure, and other related conditions, basic stress management techniques are essential. Here are some suggestions that could help to effectively manage and reduce stress 1) Keep things in perspective way 2) Be realistic while setting goals. 3) Learn time management. 4) Watch your diet and limit certain foods. 5) Use exercise to reduce stress. 6) Learn stress diversion activities like (a) Listen your favorite music (b) Play an instrument (c) Take a long walk (d) Take a trip to the beach, park, or shopping mall.

Popular Questions & Answers

Hello doctor. In winters when I watched porn penis is not erected properly but when I masturbate erection and ejaculation is perfect. What is the reason behind this?

Dr. Bhagyesh Patel 96% (5161 ratings)
MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Hello dear Lybrate user, Warm welcome to I have evaluated your query thoroughly. This is due to mind diversion to porn during that act so might be no erection. During masturbation, your full concentration is over penis, so there would be no issue in ejection. Hope this clears your query. Wishing you fine recovery. Welcome for any further assistance. Regards take care.
1 person found this helpful

I am suffering from PE. i cant stay more then 2 min in bed .please help me to solve this problem because of this my marriage life is in trouble.

Mr. M .Durga Prasad 87% (32 ratings)
MS - General Surgery
General Surgeon, Vijayawada
You can delay by simple thought diversion /gentle squeeze on both testes/tip of penis. This works in most cases. There are some drugs for which you need MD.

Hello doctor. I am of 14 years and I had a password in my phone since a year and I knew it very well. But suddenly I was just blank for a second and forgot my password. Can it be memory loss or is it common thing.

Dr. Krishna Murthy 86% (242 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Psychiatry
Psychiatrist, Hyderabad
Forgetting passwords is common that is why forgot password option is there, but if you get these blank episodes repeatedly you need to be evaluated.

Hi Dr. I dnt hav any of the bad habits lke smoking, alcohol etc. Bt my rate of ejaculation s vry fast. As soon I jst engage with my wife. My sperm ll b out. I hav tried mny thing lke kegal exercises, mind diversion & mny other things. Bt I dnt get any result. Nw i'm nt able lead my sexual life happy with my partner. Plzz tell me hw cn make my ejaculation time to maximum as possible. And it is better to take tablet lke viagra or penegra befr hvng sex. By taking ths tablets will I gt any side effects. Totally i'm nt able satisfy my wife in bed. Plz make me to gt rid of ths problem and make me to lead a better sexual life with my partner. My ejaculation rate s with in 5-10 seconds. My penis s gud in size bt only the problem s with ejaculation.

Dr. Jagadeesan M.S. 97% (9914 ratings)
MD - Psychiatry
Psychiatrist, Chennai
Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration or foreplay. It happens with minimal sexual stimulation and before the person wishes. It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction. It has probably affected every man at some point in his life. Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines. Consult a psychiatrist online or in person Your doctor will discuss your medical and sexual history with you. He or she will do a thorough physical exam. Your doctor may want to talk to your partner also. Premature ejaculation can have many causes. So your doctor may order lab tests to rule out any other medical problem. In many cases premature ejaculation gets better on its own over time. Treatment may not be needed. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. Your doctor may recommend that you and your partner practice certain techniques to help delay ejaculation, as well as medications are there to help. All the best There are excellent medications for PE, but you need to answer few questions on general health as well as PE for any psychiatrist to prescribe. Consult anyone in person or online if you wish. All the best.

Carcinoma prostate with bone metastasis (post chemotherapy and radiation) severe bladder outlet obstruction chronic kidney disease (stage 4) bicytopenia.

Dr. Bhagyesh Patel 96% (5161 ratings)
General Surgeon, Gandhinagar
Hello dear, hi Warm welcome to I have evaluated your query thoroughly. At this stage, only palliative management can be possible for the symptomatic relief as - Per urethral or suprapubic catheter for urinary diversion.- Analgesics for pain relief.- Antibiotics to prevent secondary infection.- Moral support to fight the cancer. Hope this will help you for sure. Regards.

Health Quizzes

Weight Loss - Different Surgeries Available For It!

Dr. Deepak Subramanian 88% (10 ratings)
MS - General Surgery
General Surgeon, Chennai
Sleeve Gastrectomy is a reversible surgery. True or false? Take this quiz to know more.
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