Biliopancreatic Diversion Procedure in Delhi, India

A biliopancreatic diversion is a lesser-known weight-loss procedure. It is generally a single-step procedure but can involve two steps in selective situations. The first step is the removal of a significant portion of the stomach called sleeve gastronomy, and the second step is an intestinal bypass. A biliopancreatic diversion limits food consumption and reduces the absorption of nutrients, proteins and fats. Although the procedure is effective, it involves more risk: vitamin deficiencies and malnutrition. The procedure is recommended only for people with BMI above 50. 

2. Alternate Name
   Biliopancreatic with duodenal switch
3. Body Location:

Stomach and small intestine 

4. How Performed: 

It’s done laproscopically with small holes in abdomen

Step 1: Sleeve gastrectomy - This involves removal of about 80 percent of the stomach, leaving behind a banana-shaped tube stomach, pyloric valve( transferring food to the small intestine) and duodenum. 

Step 2: Intestinal bypass - This involves bypassing the intestine by linking the end portion of the intestine to the initial small portion of the intestine, the duodenum. 

5. Preparation

How you prepare- psychological connecting

Following are the things you can do to prepare yourself for the surgery: 

• Talk to your concerned doctor, and tell them everything about your medical history, including the medicines you are taking.
•  Your doctor might suggest your pre-surgery diet. Follow it.
•  Get all the lab tests done beforehand. Stop alcohol and smoking. 
• Avoid taking aspirin, anti-inflammatory drugs and aspirin or any herbal supplements to avoid the chances of bleeding.
• If you have diabetes, tell your doctor beforehand so that the surgery is taken care of according to your insulin dose. 
• Wear comfortable clothing.
• Stop drinking and smoking. 
• Eat as much healthy as you can
• In the surgery room, you will be given general anaesthesia for painless surgery. 

6. Follow up 

 After the surgery, you have to be on strict eating habits and start workout sessions to maintain the weight loss. Immediately after the surgery, you are not allowed to eat solid food. From a liquid diet, gradually switch to pureed vegetables, followed by a soft diet that includes bread, etc. Finally, you can switch back to normal meals. Your doctor may recommend vitamins and minerals supplements for surgery to cater to nutrient deficiency due to the surgery. You may have to go for frequent medical tests to monitor your recovery process. Your body might experience body aches, tiredness, mood swings, hair thinning or hair loss as your body copes with the rapid weight loss.

8. Risks

Biliopancreatic diversion is a major surgery that has certain risk factors associated with it. Risks can be short-term or long-term. 

Short term risks involve: 

• Microbial infections
• Excessive bleeding 
• Abnormal reaction to anaesthesia
• Formation of Blood clots 
• Respiratory problems 
• Leakage in the gastrointestinal system

Longer-term risks and complications involve:

• Obstruction in the Bowel movement 
• Diarrhoea, nausea or vomiting
• Formation of Gallbladder stones
• Chances of Hernias
• Hypoglycemia: low Low blood sugar 
• Malnutrition
• Perforations in the Stomach
• Stomach Ulcers

9. Recovery

Recovery after biliopancreatic diversion may take up to three to six weeks, depending upon your condition, but the real recovery after this surgery remains for a lifetime. Care should be taken while doing daily activities like eating and bathing. Do not try any strenuous activity before you heal completely, and take as much rest as you can. Do make lifestyle changes to avoid chances of less weight reduction or weight gain.