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Bilio Pancreatic Diversion BPD

Laparoscopic Adjustable Gastric Banding :: Biliopancreatic Diversion BPD
Gastric Bypass

This operation combines removal or exclusion of 2/3rds of  the stomach along with a long
intestinal bypass which significantly reduces the absorption of fat. The capacity to eat is greater
than with the other operations, and the eventual weight loss is the best of all the operations but
if fatty foods are overeaten e.g. a hamburger and fries then diarrhoea and foul flatus will result.

Advantages:

• Greater stomach capacity (200-250 mls) therefore can eat a small main meal instead of
  an entrée portion.
• Best weight loss of all techniques 70-90% EWL over 2yrs
• Weight loss is well maintained
• Adjustable and partially reversible, but only by further surgery.
• A very good option for revision if other techniques have failed.

Disadvantages:

• Open operation ( usually), therefore greater operative risks e.g infection, Bowel leak, Clots
  to legs and lungs wound infection and hernia, chest infection. Risk of Death 1:200
• Malabsorbtion to some minerals vitamins and Protein . Patients must commit to taking
  lifelong supplements of the fat soluble vitamins ( A D E K ) Calcium and sometimes Iron.
• Risk of deficiency state e.g. Iron deficiency anaemia or osteoporosis if supplements not
  taken
• Take longer to recover ( 6-8 weeks off work)
• Increased stool frequency 2-4/day 
• Flatulance if fatty foods eaten

Residual stomach capacity 200mls and Estimated weight loss is 70-90%EWL at 2 years.