Duodenal Switch Complications

As with any bariatric surgery option, there are potential risks and complications associated with a Duodenal switch surgery. However because the duodenal switch is one of the most complex surgery options there is an increased rate of complications that come along with it. A 2011 study found that patients with a BMI below 50 experienced a serious complication at a 7% rate.

As with all bariatric surgeries, patients with a higher BMI entering surgery were more likely to experience complications afterwards. In addition, many complications post duodenal switch surgery are found to be due to patient negligence and could have been prevented if proper steps were taken.

Vitamin Deficiency

Due to the fact that the duodenal switch procedure has malabsorptive properties to achieve weight loss, one of the more common and serious side effects is the potential for vitamin deficiency. Because your body will not be absorbing as much as before, you will run the risk of not taking in the basic vitamins that your body requires. These vitamins include Vitamin A, Vitamin D, Vitamin E, Vitamin K, Iron and Calcium. Most patients will need to take a multivitamin to ensure they are getting the vitamins that their body needs.

Gastroesophageal Reflux Disease (GERD)

GERD is another potential side effect of duodenal switch surgery. Gastroesophageal Reflux occurs when acid from the stomach backs up into the esophagus causing a burning sensation. Many patients will have symptoms of GERD before surgery as it is commonly attributed to being overweight. Typically patients complaining of this will decrease in the long term as weight is lost.

Leaks or Blood Clots

As with any surgery that involves stitching of the stomach or intestines, there is the potential for leaks. In addition, bleeding or blood clots are a potential risk. This all is due to the complex nature of this surgery.

Chronic Diarrhea or Flatulence

Your surgeon will be shortening the length of your digestive tract which can lead to more frequent diarrhea or flatulence. This can be controlled by watching your diet and the amount of carbohydrates and fats you are taking in.

Spleen or Liver Injury

There is the potential that during the procedure, the spleen or liver can be injured. In some instance the spleen will have to be removed.

Additional Risks and Complications

Besides what has already been discussed here related to duodenal switch surgery there are potential complications and risks that you should be aware of that affect all bariatric surgeries in general. These include both short and long term complications that you should be discussing with your doctor.

Duodenal Switch

Duodenal switch is a bariatric surgical procedure employed to combat obesity. This form of bariatric surgery helps obese patients control their weight and begin the path to a healthier, more active lifestyle. Not all obese individuals qualify for this form of surgery. Good candidates have a body mass index (BMI) of 40 or more. Candidates with a BMI of 35 qualify if they show signs of unhealthy, weight-related symptoms such as heart disease or diabetes.

How Does it Work?

The surgery consists of a restrictive and malabsorptive surgical procedure. The restrictive element is a partial gastrectomy that reshapes and removes a portion of the stomach. The remaining portion, where the food exits, resembles a banana and has a capacity of around six ounces.

The malabsorptive element separates the flow of bile and pancreatic juices by rearranging the small intestines. Further down, the physician reconnects the two intestinal paths. The food and digestive juices combine in the last 18 to 24 inches of the small intestine. Limited fat absorption takes place as the food
heads towards the large intestine.

Advantages of Duodenal Switch

People who choose duodenal switch surgery experience greater weight loss with a low risk of weight gain. The pyloric valve, the portion of the stomach connected to the duodenum, remains intact. As a result, patients do not experience the “dumping” syndrome commonly associated with the Roux-en-Y Gastric Bypass. The malabsorptive component is partially reversible for patients with malabsorption difficulties. Duodenal switch patients experience weight loss at a more rapid pace compared to those who choose the laparoscopic banding procedure. In addition the following are all potential advantages of the Duodenal Switch procedure:

  • Typically greater weight loss over a longer period of time
  • Weight loss of up to 60% to 80%
  • Patients can eat a more “normal” and less restrictive diet compared to gastric bypass or gastric banding
  • No “dumping syndrome”
  • Intestinal rerouting is reversible
  • People with very high BMI and extreme obesity who are not eligible for other weight loss surgeries may still qualify for the Duodenal Switch

Disadvantages of Duodenal Switch

Duodenal switch surgery carries more risks compared all other traditional weight loss surgeries. Complications occur more often in this form of surgery due to a higher BMI. Patients may lose too much weight. Duodenal switch patients may experience long-term nutritional deficiencies and be subject to a lifetime of medication and special foods. Other complications include anemia, infection, gallstones and hernias. Other potential disadvantages include:

  • Most complex of all the weight loss surgery options
  • Certain foods may become intolerable
  • Increased risk for intestinal problems or gallstones
  • Potential for malnutrition or vitamin deficiency
  • Potential for frequent gas, bloating or change in body odor

Risks & Complications

Because there is a higher complexity level to this surgery, there are an increased and higher rate of risks associated. Learn more about the potential risks and complications associated with a duodenal switch procedure.

Cost

Some insurance companies may cover the full procedure, provided the patient meets certain requirements. Participation in a supervised weight loss program may be a prerequisite. Medicare and Medicaid recipients may qualify if the patient suffers from one weight-related health problem, qualifies for the procedure and an approved surgeon performs the surgery. Patients paying out-of-pocket can expect to pay between $20,000 and $25,000. For more information about the cost and procedure, contact a professional bariatric surgical center.

Diet

Since the duodenal switch involves both restrictive and malabsorptive properties, potential patients of this surgery should be aware of the dietary and lifestyle changes that will occur after surgery. Not only will diet change but your pattern of eating and the cost will all be altered. Read more about what is involved with a diet for duodenal switch patients.

Biliopancreatic Diversion

Biliopancreatic Diversion is both a restrictive and malaborptive procedure that works by altering the normal process of digestion, removing 2/3 of the stomach and rerouting food to pass by a section of the small intestine, thus limiting the amount of calorie absorption. Patients undergoing biliopancreatic diversion will feel full faster than before the surgery, which in turn cuts back the amount of food (and calories) consumed which is what leads to weight loss.

There are two versions of this surgery: Biliopancreatic diversion and a biliopancreatic diversion with duodenal switch. The difference between the two is the following:

  • Biliopancreatic Diversion – Part of the stomach is surgically removed, and the remaining portion of the stomach is connected to the lower portion or the distal segment of the small intestine.
  • Biliopancreatic Diversion with Duodenal Switch – Again a portion of the stomach is removed, but it is smaller than in the surgery without duodenal switch. And the remaining stomach remains attached to the duodenum (the upper part of the small intestine). The duodenum is connected to the lower part of the small intestine.

Advantages of Biliopancreatic Diversion

This surgery offers advantages that could make it the right decision for you. Advantages include:

  • Consistently exhibits larger weight loss totals
  • Helps improve other weight related health conditions (diabetes, high blood pressure, sleep apnea, etc..)
  • Diet less restrictive after surgery.
  • Partially reversible for those experiencing significant complications
  • Eliminates dumping syndrom common with other weight loss surgery options

Disadvantages of Biliopancreatic Diversion

This surgery does have it’s share of disadvantages that you should be aware of. Disadvantages include:

  • One of the more complicated surgeries
  • Due to complexity of surgery, higher rate of complications
  • Commonly performed as an open surgery as opposed to laparoscopically
  • Recovery time is longer. Usually from 6 to 8 weeks.
  • Require vitamin supplements for life
  • Often involves removal of gall bladder during surgery

Biliopancreatic Diversion is an option that is not as commonly performed as some of other options but does offer advantages that make it an attractive choice for some. Please consult with your doctor to discuss if Biliopancreatic Diversion is the right choice for you.

Vertical Banded Gastroplasty

Vertical banded gastroplasty, also known as “stomach stapling” is a purely restrictive bariatric surgery procedure where the stomach is stapled and divided, forming a a small pouch and limits the amount of food that can be taken in. The outlet of this new pouch is restricted by a band that helps create a feeling of fullness and decreases appetite. The band used in this procedure is non-adjustable which is part of the reason why this form of surgery has been falling out of favor with bariatric surgeons in recent years. Newer procedures make use of adjustable bands and do not require staples making newer methods much safer options.

Advantages of Vertical Banded Gastroplasty

  • Patient avoids “dumping syndrome”
  • There is no nutritional deficiencies since this is not a malabsorptive procedure

Disadvantages of Vertical Banded Gastroplasty

  • Success based upon patients strict adherence to diet
  • Classified by the American Medical Association as a “Severely Dangerous” operation
  • High fiber foods and denser natural foods become harder to eat while highly refined junk foods are easier to digest, making adherence to a healthy diet more difficult
  • Reversal of procedure is very difficult
  • Band is not adjustable

While there are instances where vertical banded gastroplasty (stomach stapling) may be the best option for you, it has been falling out of favor in recent years for more effective and safer procedures. There are still many very reputable doctors and hospitals performing this procedure all around the country. You should discuss all of your options with your doctor before making your choice for bariatric surgery.

Gastric Plication Complications

While gastric plication has shown some very promising early results, most notably in a Brazilian study conducted between 2007 and 2010 published in the Bariatric Times (http://bariatrictimes.com/2010/05/19/..), there are some drawbacks you should be aware of with this procedure.

In the study referenced above, there were no complications reported during the procedure itself, however due to the nature of the surgery, which is similar in nature to other stomach capacity reduction surgeries such as vertical sleeve surgery, there is the potential for the following complications during or shortly after gastric plication surgery.

  • Esophagitis
  • Stenosis
  • Fistulas
  • Gastric Leaks

Both leaks and fistulas are reported in nearly one percent of cases and can be very difficult to treat and are the biggest threat to the patients health during surgery

Non-Medical Related Drawbacks

Aside from medical complications there are other potential drawbacks which can be even bigger obstacles for many people. Due to the young age of this procedure, gastric plication is not yet fully supported in the United States. This means that the FDA hasn’t fully approved it’s use and insurance companies are unlikely to cover the costs of this procedure. Until more studies are done and more data is available covering the long term complications and success rates, it will continue to be a surgery that is more common to be performed abroad than it is within the U.S. This can be a major hurdle for many people.

Additional Weight Loss Surgery Options

While there are more commonly selected choices such as gastric bypass, gastric banding or the increasingly popular gastric sleeve surgery. There are other weight loss surgery options that may be more appropriate for many people. Every patient is unique and the surgery that is the best choice for one person may not be the best choice for another.

Alternative surgery options can be geared towards patients who are “super-obese” as these patients are more prone to complications. Alternative choices can include the following:

Healthy Diet Plan

Vary Your Food Choices

You should vary the foods you eat because every food contains different nutrients and vitamins that your body needs. Varying your diet will go a long way in ensuring your body is balanced and healthy.

Load Up On the Proper Foods

Your diet should be heavy in complex carbohydrates, fiber, vitamins, and minerals while low in fat and free of cholesterol. In addition you should include low fat dairy products, lean meats, fish and poultry.

Limit the Unhealthy Foods

You want to limit as much as possible sugary foods, refined grains such as white bread, and salty snack foods. Sugar is added to a vast array of foods and should be watched closely. In addition unhealthy fats, such as saturated animal fat should be replaced with lean meats.

Moderate Portion Sizes

Portions sizes have expanded over the years which is reflected in peoples weights. Don’t feel obligated to eat everything, or try ordering appetizer size portions.

What is BMI

BMI refers to the Body Mass Index, which is a number calculated from a person’s weight and height that can be a somewhat reliable indicator of body fat for most people. While BMI does not measure body fat directly, the research has shown that BMI correlates to direct measures of body fat. BMI is an inexpensive and easy to measure method of screening for weight categories that may lead to health problems.

While BMI can not directly indicate a health problem it is a good tool to serve as an indicator to a potential health problem. If someone has a high BMI, further tests should be performed to further determine whether or not their is an actual health risk that needs correction. Further tests can include skinfold thickness measurements, evaluations of diet, physical activity, family history, and other appropriate health screenings.

How is BMI Calculated

The Formula is: weight (lb) / [height (in)]2 x 703.
Calculate BMI by dividing weight in pounds (lbs) by height in inches (in) squared and multiplying by a conversion factor of 703.

Example: Weight = 180 lbs, Height = 6’0″ (72″)
Calculation: [180 ÷ (72)2] x 703 = 24.41

BMI Chart

The following chart illustrates how to score BMI results and what each number means in regards to overall health from a Body Mass Index perspective.

Risks for a High BMI

If you calculate your BMI and it tells you that you are overweight or even obese, you should be aware that you are potentially at increased risk for a variety of conditions including:

.Hypertension
.Type 2 diabetes
.Coronary heart disease
.Stroke
.Gallbladder disease
.Osteoarthritis
.Sleep apnea and respiratory problems
.Certain cancers

Weight Management

If you’re overweight, you may feel that you have tried everything to lose weight. However, done correctly, there are a variety of ways to achieve the results you’re looking for. Beyond just looking good, weight management can improve your health and drastically improve your lifestyle. Among the many ways to lose weight you will find not just temporary fixes, but total and permanent transformations.

The basics of weight loss are universally the same. Change your eating habits and move more. Get rid of fatty heart damaging food and replace it with whole grains, fruits, vegetables, and lean meat. Make it a habit to take a walk. Walking is an excellent way to get used to exercise without it feeling like a workout. With this, you will see a slow change in your body. For more dramatic results, you will need to burn more calories than you take in. Slowly increase your walking speed. Add some free weight repetitions to build some muscle while burning fat.

The Science Behind Weight Management
Weight management and weight loss can essentially be broken down to science and basic math. The amount of energy (calories) you get from food is balanced with the energy your body uses for things like breathing, digesting, and exercising.

The math portion comes into effect when you look at the notion of food intake and enery your body uses:
Weight stays the same – You eat the same amount of energy (calories) as you burn off
Weight gain – You eat more energy (calories) than you burn off through exercise
Weight loss – You burn more energy than you are taking in

To maintain a healthy weight you should strive to find a healthy balance between the amount of calories you are taking in with the amount of calories you are burning off. To achieve weight loss you should aim to take in 500 fewer calories than you are burning off each day. Looking at the above formula you can see that this 500 calorie difference can be achieved through either reducing your caloric intake or increasing your physical activity. Ideally however you will choose a balance of the two to achieve a healthy weight reduction.

Bariatric Surgery Resource

Welcome to The Bariatric Surgery Resource. This site focuses on providing you with all the information you need when considering your weight loss options. Whether you are considering weight loss surgery and one of the many options such as gastric bypass, gastric sleeve, gastric banding or weight management through a healthy diet and exercise, we can help you by giving you all the information you need to make an informed decision.

The United States is now considered the most overweight country in the world with over 30% of Americans classified as obese. In addition, another 1/3 of Americans are considered overweight, which only further emphasizes the fact that this is a major problem facing a tremendous amount of people today. Many people simply can not shed the weight and keep it off effectively through proper dieting and exercise. This has necessitated the need for alternate solutions to combat obesity in America. This is why we have seen the increase in popularity of bariatric surgery (weight loss surgery) and the ever increasing variations of this procedure to help those who want to lose their excess weight but have difficulty doing it through more traditional methods.

Bariatric surgery is known to be the most effective treatment for morbid obesity and for people with a body mass index over 40. We recommend you consider all your options and consult a medical professional when deciding if bariatric surgery is the right choice for you.

How to Use this Site

This site is designed to give you an in-depth look at all of your choices concerning weight loss surgery. For example, you may be wondering:

  • Is bariatric surgery right for me?
  • Which procedure is most appropriate for me?
  • How can I select the best bariatric surgeon?

Bariatric surgery can make a dramatic change in your life but it doesn’t come without risk and potential drawbacks. We want you to be prepared and understand everything you are dealing with before you make one of the most important decisions of your life.

There are always new techniques and methods being introduced and new studies and data being released related to weight loss and bariatric surgery so please visit often to stay abreast of the latest news and information. While we strive to have as much information for you as possible, if there is something more you’d like to know or simply have a comment or suggestion, please don’t hesitate to contact us.

New Features

Please take a look at our latest creation which is an infographic that compares three of the most commonly chosen weight loss surgeries.