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Overview

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.

Indication

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

Stricture Urethra - Signs You Should Not Ignore!

Dr. Shilpi Tiwari 84% (34 ratings)
MBBS, MS-General Surgery, DNB
Urologist, Delhi
Stricture Urethra - Signs You Should Not Ignore!
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.
2533 people found this helpful

What Is Urethral Stricture?

Dr. Sarwar Eqbal 87% (10 ratings)
MBBS, MS - General Surgery, DNB - Urology
Urologist, Delhi
What Is Urethral Stricture?
The urethra is a thin tube that is responsible for carrying urine from the bladder. The urethra is wide enough to facilitate a free flow of urine. However, in some cases, the tube can narrow down and it can restrict urinary flow. This condition is known as a urethral stricture. It is a condition that affects mostly men. Causes: The inflammation of the tubular tissues or the presence of scar tissue is the number one cause for urethral stricture. In some cases, an accident or the injury to the groin area can also lead to the formation of such thin tubes. The other factors can include pelvic fractures, radiation, urinary infection and in some cases even STDs(Sexually Transmitted Disease). Symptoms: Most of the symptoms of Urethral stricture are mild. Only in some rare cases, the symptoms can be extreme. These can include weak or restricted urine flow, frequent urges to urinate, and feeling of heaviness in the bladder, a burning sensation during urination, swelling and pain while urinating. Sometimes your urine may discharge volts of blood and the color of urine may change. Diagnosis: Diagnosis is by a physical examination and by analyzing the urine samples. In most of the cases, the thickness of the walls is measured by cystoscopy. The rate of the urine passed may also be checked for identifying the symptoms. Treatment: Treatment depends on the severity of the condition. Nonsurgical methods aim to improve the width of the urethra. This is done by using an instrument called a dilator. This is done as an outpatient procedure. This procedure is the most common method done and is done for most of the milder cases. Surgery is another option. The surgery aims to remove the heaviness of the urethra and enlarges the size of the flow. Urine Flow Diversion: This is done in extremely rare cases if the bladder has to be completely removed. In those cases, hole in the abdomen is done and urine is bypassed to that hole. However, this is an extremely rare scenario. Prevention: Try to avoid injuries in the groin area. If you are playing sports or a fitness enthusiast, use proper protection for your abdominal and groin regions. Try to always have safe sex and if you feel that there is some discomfort or some uneasiness while passing urine, do consult with a doctor immediately. In many cases, the condition can be avoided if proper precautions are taken.
1 person found this helpful

Does Bariatric Surgery Reduces The Risk Of Cancer?

Dr. B N Shukla 86% (21 ratings)
Fellowship in Minimal Access Surgery, Fellowship in Bariatric Surgery, M.S.
Bariatrician, Lucknow
Does Bariatric Surgery Reduces The Risk Of Cancer?
Obesity can make life miserable. From unhealthy eating habits to unhealthy lifestyles and medical conditions, obesity can be an amalgamation of many factors. Obese people are a greater risk of suffering from many serious health complications like type-2 diabetes, mood swings, and depression, cardiac problems, high blood pressure and high cholesterol, to name a few. It does not stop there. More alarming is the fact that obese people are an increased risk of suffering from different types of cancer. Bariatric surgery comes as a saviour for highly obese people (with a BMI over 40), who have tried every possible treatment under the sun to lose weight without any success. Bariatric surgery has helped many severely obese people attain a healthy weight. Bariatric surgery can be of three types; Gastric bypass surgery (Roux-en-Y): This is one of the most common types of weight-loss surgery practised worldwide. The procedure involves rearranging (dividing) the stomach into a smaller upper pouch and a larger lower part. The smaller pouch is then connected to the small intestine. The food consumed will pass into the small intestine through the pouch. The idea is to rearrange the stomach in such a way that a person consumes a lesser quantity of food. Gastric banding (Laparoscopic Adjustable Gastric Band): In this procedure, the surgeon creates a small pouch at the upper part of the stomach by placing a band (lap band or A-band) around it. The pouch, true to its name, is used to hold the food consumed. The purpose of placing a band around the stomach (upper part) is to reduce the intake of food. Sleeve Gastrectomy (Gastric Sleeve surgery): In Sleeve Gastrectomy, surgeons remove a large portion of the stomach, leaving behind only a small sleeve-like pouch (hence the name). Like the other two surgeries, sleeve gastrectomy also aids in limiting the consumption of food. Duodenal switch: The fourth type of bariatric surgery, Duodenal switch with biliopancreatic diversion, is not very commonly used. Bariatric surgery has several health benefits. In addition to the weight loss, it plays a pivotal role in lowering the incidences of Type-2 Diabetes, depression, anxiety, coronary artery problems, sleep apnea cardiovascular diseases. Research also suggest that bariatric surgery has been instrumental in reducing the chances of cancer (especially colon and breast cancer) by as much as 60%. The correlation between weight loss and reduced cancer instances is still a debatable topic. Some researchers and oncologists believe that the weight loss (bariatric surgery) brings about a hormonal modification which prevents the growth of tumour cells. Another study links obesity with an increased inflammation. In many cases, inflammation acts as a catalyst, accelerating the growth of cancer cells. Research is still going on to understand this correlation (obesity and reduced cancer rates) better. Bariatric surgery has its share of risks and demerits. Consult your physician and get yourself thoroughly examined before opting for the surgery.
1817 people found this helpful

Depression - How To Manage It?

Ms. Kaustubhi Shukla 90% (123 ratings)
M.Sc - Psychological Counseling, B.A ( Hons) - Psychology
Psychologist, Delhi
Depression - How To Manage It?
Depression, a psychological condition marked by sadness, lethargy, exhaustion, helplessness and hopelessness can develop among men and women of any age, at any point in their lifetime. It is difficult to pinpont the exact cause of depression, however, financial setback, failure in a relationship, academic under-performance, vocational under-achievement and several other socio-economic stressors of this sort are known to cause Depression how we know it in current times. Prolonged and untreated Depression can compromise the depressed individual's immunity making them vulnerable to several other health problems. Therefore, one must make efforts to get out of a depressed mode as soon as possible. While dealing with feelings of sadness it is important to accept one's condition, identify the reasons behind those feelings and try as much as possible to come out of it using one's own efforts. In order to recognise your stressors and work your way around those you must- Sleep well: While you are resting through various stages of sleep your body is getting ready to take on more life for when you wake up and get going. A good night's sleep rejuvinates the body and repairs the day-to-day wear-and-tear that the body undergoes. Not getting enough rest on the other hand can lead to many health problems, further worsening a depressed person's condition. Therefore, sleeping is important. If needed, you must force yourself to sleep. Eat well: A depressed person might binge eat and/or over eat or avoid food altogether. Many clinically depressed people report indulging themselves in foods like chips, chocolates and such other high-calorie foods. Such an eating pattern will lead to weight gain and predispose one to obesity and obesity-related health problems. Alternately, if one lacks the desire to eat anything, then, this too can lead to adverse effects as the body's nutritional balance gets disturbed. So, make an effort to keep your body nourished at all times. Exercise: Regular exercise is very useful in that it acts as a diversion from stressful or negative thoughts and also helps in keeping the body active. In case you do not like to exercise, you can opt for jogging or running. Even a simple walk out in the open can be beneficial. Going out, inhaling fresh air, connecting with the nature can all help shift focus onto the positive aspects of life and enhance the quality of your thoughts. Small windows of positive thoughts in one's daily life can do wonders for anyone. Keep yourself engaged: Engaging in activities that one doesn't do every day can distract your mind and also make you creative as well as productive. Such activities might include gardening, painting, cooking, riding a bicycle and the likes. While engaging in such activities can keep you busy, keeping your mind off from wandering to catastrophic thoughts you might even discover some of your hidden talents in the process. Trust in your abilities: No one is perfect and many times one's social, economic and/or physical conditions are not contributing favorably in achieving one's ambitions and desires. In such conditions it is important to focus over what one is capable of doing and making earnest efforts at making the best out of one's situation. Sooner or later change will occur. These are some of the ways you can use to fight away depression.
2549 people found this helpful

Stricture Urethra - Signs You Are Suffering From It!

Dr. Rajesh Gulia. 86% (15 ratings)
MBBS MS DNB MNAMS NYAMS
Urologist, Mohali
Stricture Urethra - Signs You Are Suffering From 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.
3578 people found this helpful

Popular Questions & Answers

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. 95% (9156 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 93% (3025 ratings)
FMAS, MS
General Surgeon, Gandhinagar
Hello dear, hi Warm welcome to Lybrate.com 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.

I want a medicine name which help me to increase sex timing. Name any tablet which is use full for it.

Dr. B.R. Murthy 92% (148 ratings)
M.Sc - Psychology, MS- Sexualty, PGDGC, DAFE
Sexologist, Visakhapatnam
Some techniques are very important to get good sex. Kegel exercises and brisk walking. Squeeze techniques and mind diversion helps very lot. Medicine should be take under Care of physician by some blood and sperm investigations.
1 person found this helpful

My mother has gone through craniotomy and then cranioplasty. 2 weeks after cranioplasty CT scan resulted hydrocephalus. What is the treatment of hydrocephalus?

Dr. Savitr Sastri 87% (73 ratings)
MS - General Surgery, MBBS, MCh - Neuro Surgery
Neurosurgeon, Hyderabad
It would involve some sort of diversion procedure either with a shunt out endoscopically if she is symptomatic for the hydrocephalus.

I used to masturbate daily about 5 to 10 times a day. Is it okie or it is a sin. This cause any infertility in future. R any sex related problems.

Dr. Reena Kawatra 92% (4118 ratings)
MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
Too much in excess of everything is bad for health if not a sin ,so you may build up some other diversion of mind rather than masturbate. No it doesn't cause any infertility but it certainly affects sexual interests in future.
1 person found this helpful
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