Biliopancreatic diversion

The Biliopancreatic Diversion (BPD) is a purely malabsorptive operation. It was pioneered by Nicola Scopinaro from Italy, and has outperformed all other operations in regards to the amount of weight lost (up to 80% of excess weight). Unfortunately, compared to the Lap Gastric Band, it has a higher operative complication rate and overall mortality.

Biliopancreatic diversion with duodenal switch: The operation involves excising half of the stomach (the acid producing section) thus decreasing the size of meals able to be eaten. The small bowel is then cut and joined to the stomach and itself as seen in the diagram opposite (Duodenal switch; BPD+DS). These connections divert food from the digestive juices of the pancreas and liver until a very small section of small bowel just prior to its connection to the large bowel. The result is malabsorption of nutrients, in particular fat. These invariably leads to a certain amount of diarrhoea (this settles with time).

This operation requires life long follow up to assess for nutrient deficiencies which may appear in the long term.