Despite the Risks of Duodenal Switch, Morbidly Obese Patients Choose Duodenal Switch Weight Loss Surgery
A biliopancreatic diversion with duodenal switch weight loss surgery (DS/BD) is performed on patients who suffer from severe morbid or comorbid obesity. During the procedure, a portion of the stomach is removed, thereby restricting the amount of food that can be ingested. This also causes the patient to feel full after eating smaller amounts. Part of the small intestine is bypassed in the reattachment of the stomach. This causes malabsorption, which decreases the amount of calories absorbed during digestion. The process through which food is broken down by bile and digestive juices is altered, which leads to further weight loss. In addition to promoting weight loss, the surgery can help with other illnesses related to obesity. All precautions are taken to minimize the potential risks that must also be considered.
Bariatric Surgery Encourages Weight Loss
The benefits of a BD/DS can prolong your life and improve your quality of living in extreme ways. Excess weight is typically reduced by 40 to 80% as the result of a duodenal switch procedure. Such a large amount of weight loss can help you recover from or avoid comorbid illnesses caused by obesity, and remission or avoidance of the illnesses saves you from taking the medications accompanying them. Given the impressive results, it isn’t difficult to understand why the number of duodenal switch surgeries is on the rise.
Surgery Often Relieves Patients of Fatal Illnesses
Obesity leaves you susceptible to several serious illnesses. It can lead to type 2 diabetes, a condition in which your blood sugar level is too high. Diabetes puts you at risk for stroke, kidney disease, coronary heart disease, and blindness. Having a high body mass index (BMI) can cause plaque buildup in the arteries. If the plaque ruptures and forms a blood clot close to the brain, the resulting restriction of blood and oxygen may induce a stroke. The same plaque buildup near the coronary arteries can block oxygen-rich blood from reaching your heart, causing angina or heart attack.
Obesity is also a known cause of high blood pressure, triglycerides, bad cholesterol, and low good cholesterol. Duodenal switch weight loss surgery decreases the chances of developing endometrial, colon, breast, and gallbladder cancers. Osteoarthritis sometimes results from the deterioration of joints caused by excess weight. Bariatric surgery decreases the possibility of sleep apnea, a dangerous sleep disorder in which stored neck fat can prevent breathing. Chances of having gallstones, obesity hypoventilation syndrome, and reproductive issues (in women) are also reduced after the BD/DS.
Risk of Weight Gain or Insufficient Weight Loss Following Surgery
The beneficial surgery comes with risks too. Patients must maintain an adjusted diet and must exercise regularly to ensure successful weight loss after surgery. Part of the weight loss treatment entails visits with a behavioral therapist to prepare them for post-op life. Some patients have reported insufficient weight loss after surgery. Many of them neglected to follow their post-op diet and exercise programs. It is possible for the digestive tracts of patients who undergo a malabsorption procedure to adapt to the surgical changes over time, allowing higher absorption of fats. The only solution for continued weight loss in this case is to undergo a second surgery.
Surgery May Cause Deficiencies of Essential Vitamins and Minerals
Malabsorption plays a key role in BD/DS surgery by reducing the amount of fats absorbed during digestion. It also prevents the body from absorbing full amounts of essential nutrients. The resulting lack of iron and calcium may lead to anemia or osteoporosis. Deficiencies in thiamine (though rare) and vitamins A, D, E, and K can invite beriberi, which causes damage to the nervous system if it goes untreated. A type of protein deficiency malnutrition occurs in 18% of patients. Doctors require patients to continue their follow-up visits throughout their lifetimes, and regular blood tests are administered for early detection of any dangerous conditions. Most patients avoid all maladies simply by taking supplements prescribed following surgery.
Dumping Syndrome and Leakage
Dumping syndrome occurs when digestive juices transfer food from the stomach to the small intestines too quickly. Symptoms of gastric dumping include diarrhea, nausea, rapid heartbeat, flushing, and fainting. Simple dietary changes are normally sufficient to correct the problem. Otherwise, your physician will prescribe medication. Very rarely, a second surgery is needed.
Leakage from the point where the stomach and intestines are reattached can occur and can be serious. Patients are checked for leakage before being released from the hospital. Leakage only occurs in 1 to 2% of cases.
Gallstones, Hernia, and Strictures
The surgeon will decide whether to remove your gallbladder and appendix during surgery, as development of gallstones is common. Normally, if the gallbladder is healthy, it is left intact and the patient is given medicine to prevent problems. In some cases, hernias and strictures may cause late problems. A hernia occurs when an organ pushes through a muscle’s weak area. Strictures describe the narrowing of the opening between the joined sections of intestines. Strictures can be fixed with a simple procedure using a balloon to expand the opening, and no further surgery is needed.
Low Risk of Complication and Good Success Rate
Physicians recommend this surgery for patients who have BMIs of at least 40 when all other efforts at weight loss have been exhausted. Your surgeon will take inventory of your current health condition, your weight, your age, and any medications you take before recommending a surgery. Whether the procedure is performed laparoscopically or open depends on the difficulty of gaining necessary access. As with any surgery, there is a slight risk of death. Overall, the risk of complications associated with the duodenal gastric weight loss surgery is low. Most complications are minor. The weight loss from a duodenal switch tends to be greater than that of other types of gastric weight loss procedures. Your physician can guide you in how to proceed by evaluating your situation and providing statistics specific to your situation.
If you’re interested in having a biliopancreatic diversion with duodenal switch weight loss surgery, read our guide to bariatric surgery insurance and financing.