Duodenal Switch

THE DUODENAL SWITCH PROCEDURE GENERATES WEIGHT LOSS BY RESTRICTING THE AMOUNT OF FOOD THAT CAN BE EATEN WITH THE REMOVAL OF STOMACH OR VERTICAL GASTRECTOMY

The Duodenal Switch procedure, also known as the Bilio-Pancreatic Diversion or the Vertical Gastrectomy with the Duodenal Switch. This procedure generates weight loss by restricting the amount of food that can be eaten with the removal of stomach or vertical gastrectomy (the greater curvature so that the volume is approximately one third its original) and by limiting the amount of food, specifically fat, that is absorbed into the body Duodenal Switch. This has a significant component of malabsorption, which seems to augment and help maintain long-term weight loss.

The malabsorptive portion of the surgery reroutes a large portion of the small intestine, creating two separate pathways and one common pathway. The shorter of the two pathways, the digestive loop, takes food from the stomach to the large intestine. The by-far longer pathway, the Bilio-pancreatic loop, diverts bile from the liver to the common path. The common path is a stretch of small intestine, approximately 75-100 centimeters long, in which the contents of the digestive path mix with the bile from the Bilio-pancreatic loop before emptying into the large intestine. The point of this arrangement is to reduce the amount of time the body has to capture and absorb nutrients and calories from food in the small intestine as well as severely limit the absorption of fat. Which seems to augment and help maintain long-term weight loss?

ADVANTAGES OF THE DUODENAL SWITCH PROCEDURE

The main advantage of the Duodenal Switch surgery is that by using two approaches, weight loss tends to be achieved more quickly and more permanently. The more normal stomach allows for better eating quality The patient experiences no Dumping Syndrome because the pylorus is preserved as the pyloric valve between the stomach and small intestine is preserved. People who have undergone the DS do not experience the Dumping Syndrome common with people who have undergone the Roux-en-Y Gastric Bypass Surgery. Those who undergo the Duodenal Switch often find that comorbidities such as Dumping Syndrome, Diabetes mellitus Type 2, Arthritis, and high blood pressure are significantly relieved in a short time after the surgery. Gastric dumping syndrome, or rapid gastric emptying, happens when the lower end of the small intestine, the jejunum, fills too quickly with undigested food from the stomach. "Early" dumping begins during or right after a meal. Symptoms of early dumping include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. "Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness. Many people have both types. In addition, people with this syndrome often suffer from low blood sugar, or hypoglycemia, because the rapid "dumping" of food triggers the pancreas to release excessive amounts of insulin into the bloodstream.

CAUSES OF DUMPING SYNDROME

Certain types of stomach surgery that allow the stomach to empty rapidly are the main cause of dumping syndrome. Patients with Zollinger-Ellison syndrome, a rare disorder involving extreme peptic ulcer disease and gastric-secreting tumors in the pancreas, may also have dumping syndrome. Finally, patients with connective tissue conditions such as Ehlers-Danlos syndrome can experience "late" dumping as a result of decrease motility.

DIAGNOSIS OF DUMPING SYNDROME

Doctors diagnose dumping syndrome primarily on the basis of symptoms in patients who have had gastric surgery. Tests may be needed to exclude other conditions that have similar symptoms.

DISADVANTAGES OF THE DUODENAL SWITCH PROCEDURE

The malabsorptive element of the Duodenal Switch Procedure is so potent that those who undergo the procedure must take vitamin and mineral supplements above and beyond that of the normal population. Those that do not run the risk of deficiency diseases such as anemia and osteoporosis.

Because gallstones are a common complication of the Duodenal Switch Procedure, it is necessary to remove the gall bladder during surgery.

EFFECTIVENESS OF THE DUODENAL SWITCH PROCEDURE

WEIGHT LOSS%:

3 months - 29 and 37%

6 months - 51 and 55%

24 months - 91 and 80% of the over weight