Biliopancreatic Diversion with Duodenal Switch

Biliopancreatic diversion with duodenal switch (BPD-DS) combines a sleeve gastrectomy with a long intestinal bypass. Food travels down a shortened limb of bowel, while bile and pancreatic juice travel down a separate limb, and the two meet only in the last 75 to 150 cm. You eat less and absorb much less fat.

It produces the greatest and most durable weight loss of any standard operation and the highest remission rate of type 2 diabetes. The price is a real risk of protein, vitamin and mineral deficiency, so strict supplements and blood tests for life are not optional.

What Biliopancreatic Diversion with Duodenal Switch involves

The operation is done by keyhole surgery through five or six small ports. First the outer curve of the stomach is stapled away over a sizing tube, leaving a sleeve that keeps the pylorus valve. The duodenum is divided just beyond the pylorus. The small bowel is measured back from the large bowel: it is cut at around 250 to 300 cm, and the lower end is brought up and joined to the duodenum to carry food. The upper end, carrying digestive juices, is joined to the food limb 75 to 150 cm before the colon to create the common channel. The gaps in the bowel's supporting tissue are stitched to prevent internal hernias and the joins are leak tested.

Who is a good candidate for Biliopancreatic Diversion with Duodenal Switch?

Reserved for severe obesity or for weight regain after a sleeve, in people who will reliably take supplements and attend follow-up.

• BMI of 50 or above, where a sleeve or bypass alone often falls short
• Poorly controlled type 2 diabetes with severe obesity
• Inadequate weight loss or regain after a previous sleeve gastrectomy
• People with proven commitment to lifelong vitamins and blood tests

Es ist normalerweise nicht die richtige Wahl, wenn:

• Anyone unlikely to take daily supplements or return for monitoring
• Inflammatory bowel disease, chronic diarrhoea or existing malabsorption
• Severe liver cirrhosis or untreated eating disorder
• Women planning pregnancy within 18 months
• People with limited access to bariatric follow-up at home

Technikoptionen

• Classic BPD-DS: Two bowel joins and a common channel of about 100 cm. Maximum effect, highest nutritional risk.
• SADI-S (single anastomosis): One join with a longer common channel of 250 to 300 cm. Simpler surgery and fewer deficiencies with slightly less weight loss.
• Two-stage approach: Sleeve first, then the intestinal part 12 to 18 months later for very high-risk or very heavy patients.
• Revisional duodenal switch: Adding the bypass to an existing sleeve after weight regain.

Was passiert während Ihrer Behandlung

Surgery takes 2.5 to 4 hours under general anaesthesia. You are walking the same evening, start sips of fluid the next day after a leak check in many units, and stay 3 to 5 nights with blood thinning injections.

Vorbereitung auf Ihre Reise

Plan for 8 to 12 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stoppen Sie das Rauchen und Nikotin mindestens vier Wochen vor und nach der Operation; es ist die größte vermeidbare Ursache von Wundproblemen
• Erzählen Sie dem Team von allen Medikamenten und Ergänzungen, die Sie einnehmen; Blutverdünner, einige Kräuterprodukte und Hormonbehandlungen müssen möglicherweise auf Anraten Ihres Arztes unterbrochen werden
• Vereinbaren Sie, dass jemand mit Ihnen reist oder erreichbar ist, und halten Sie die ersten Tage zu Hause frei von Arbeit und Heben
• Buchen Sie einen veränderlichen Rückflug; Ihr Chirurg bestätigt, wenn Sie fit sind

Genesung und Ergebnisse

Diet moves from liquids to puree to soft food over 4 to 6 weeks, with a protein target of 80 to 100 g a day. Desk work is possible at 2 to 3 weeks. Weight falls fastest in the first year and levels off by 18 to 24 months. Loose, strong-smelling stools and wind are common, especially after fatty meals. Blood tests are needed at 3, 6 and 12 months and then yearly for life.

• Back to everyday activity: 2 to 4 weeks
• When results show: Most weight lost by 12 to 18 months
• How long they last: Durable; typically 70 to 80 percent of excess weight kept off with lifelong follow-up

Sicherheit, Risiken und Revisionspolitik

This is the most complex common bariatric operation, with higher early and late risks than a sleeve or bypass.

• Leak from a staple line or bowel join, or bleeding, in the first weeks
• Blutgerinnsel in den Beinen oder Lungen
• Protein malnutrition, sometimes needing the common channel lengthened
• Deficiency of vitamins A, D, E and K, iron, calcium, zinc and B12, leading to anaemia, bone thinning or night blindness if neglected
• Frequent oily stools, wind and odour
• Internal hernia or bowel obstruction
• Gallstones and kidney stones
• Excess or loose skin after major weight loss

Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.

Cost of Biliopancreatic Diversion with Duodenal Switch in Türkiye

Clinic-Y does not publish a single price for Biliopancreatic Diversion with Duodenal Switch, because the honest figure depends on your case. What moves it:

• Classic two-join operation versus SADI-S
• Primary versus revisional surgery
• Length of hospital and intensive care stay
• Pre-operative work-up: endoscopy, sleep study, cardiac and nutritional tests
• Staplers and energy devices used

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