Complications and Risks of
Biliopancreatic Duodenal Switch Bypass
Judging the complications and risks of duodenal switch stomach bypass
treatment of obesity involves an assessment of operative, perioperative
and long term complications. Also, the risks must be weighed against the
known health risks of severe obesity.
Bypass Complications and Health Risks
- Complication rates in the early post-operative period, such as infection,
dehiscence, leaks from staple breakdown, stomal stenosis, ulcers and
deep thrombo-phlebitis may be as high as ten percent or more. However,
the combined risk of the most serious complications of gastrointestinal
leak and deep venous thrombosis is less than one per cent.
- Later, other problems may arise and may require corrective surgery.
The mortality and morbidity rates of follow-up operations are higher
than those of initial bariatric surgery.
- Duodenal switch bypass operations may also cause post-operative dumping
syndrome. This occurs when the food in the stomach moves too rapidly
through the small intestine. Symptoms of dumping include: nausea, sweating,
feeling faint, and diarrhea after eating. However, the
risk of dumping syndrome is lower for duodenal switch than regular
biliopancreatic diversion surgery as the former procedure maintains
the pyloric valve intact.
- Nearly 30 percent of patients who have stomach bypass surgery develop
nutritional deficiencies because they do not adhere to their post-operative
guidelines concerning the need for nutritional supplements. Bariatric
bypass patients have a high risk of chronic anemia or conditions like
osteoporosis and metabolic bone disease.
Complication Rates of Biliopancreatic Diversion
with Duodenal Switch
Deep vein thrombophlebitis 0.7%
Non-fatal pulmonary embolus 0.5%
Acute respiratory distress syndrome 0.25%
Gastric leak and fistula 2.0%
Duodenal leak 1.5%
Distal Roux-en-Y leak 0.25%
Postoperative bleeding 0.5%
Abscess unrelated to leaks 0.25%
Duodenal stomal obstruction 0.75%
Small bowel obstruction 2.0%
[Source: American Society of Bariatric Physicians]
Method and Procedure
Surgical Operation Diagram
Weight Loss and