BILIOPANCREATIC DIVERSION (BPD)

How Biliopancreatic Diversion (BPD) Works

BPD is a two-part surgery that involves the following:

1. Stomach Reduction (Sleeve Gastrectomy): The first part of the procedure involves removing a significant portion of the stomach, typically 70-80%. This creates a smaller stomach pouch, limiting the amount of food that can be eaten and reducing hunger.

2. Intestinal Bypass (Malabsorption): The second part involves rerouting a portion of the small intestine, bypassing a significant part of the stomach and intestines. This limits the area where nutrients are absorbed and reduces the number of calories the body can absorb. This creates a “malabsorptive” effect, which leads to weight loss as fewer calories are absorbed from food.

By combining a smaller stomach with a reduced ability to absorb nutrients, the surgery significantly reduces food intake and calorie absorption.

Benefits of Biliopancreatic Diversion (BPD)

• Significant Weight Loss: BPD leads to substantial weight loss, with patients typically losing 70-80% of their excess weight within the first 1-2 years following surgery.

• Improvement of Health Conditions: BPD can improve or resolve a variety of obesity-related conditions, such as type 2 diabetes, high blood pressure, sleep apnea, and heart disease.

• Sustained Long-Term Results: Due to the combination of both restriction and malabsorption, weight loss tends to be sustained over the long term.

• Reduced Hunger: The procedure significantly decreases hunger and food cravings by reducing the size of the stomach and altering gut hormones that control appetite.

Who Is a Good Candidate for Biliopancreatic Diversion (BPD)?

BPD is typically recommended for individuals who:

• Have a BMI of 40 or higher (severe obesity), or a BMI of 35 or higher with obesity-related health problems.

• Have not had success with other weight loss methods, such as diet and exercise.

• Are committed to making lifelong changes in diet, including eating high-protein, low-fat, and low-carbohydrate foods.

• Are prepared for long-term supplementation of vitamins and minerals due to the malabsorptive nature of the procedure.

• Have severe obesity-related health conditions that would benefit from more drastic weight loss.

The Surgical Procedure

• Minimally Invasive: BPD can often be performed laparoscopically, which involves smaller incisions and less pain compared to traditional open surgery.

• Duration: The procedure typically takes 3-5 hours to complete.

• Hospital Stay: Patients generally stay in the hospital for 3-5 days for post-surgical monitoring and recovery.

• Recovery Time: Recovery time varies, but most patients can resume light activities within 4-6 weeks, with full recovery taking 2-3 months.

Dietary Guidelines After Biliopancreatic Diversion (BPD)

• Initial Diet: After surgery, patients follow a liquid diet for the first few weeks to allow the stomach and intestines to heal. Gradually, they can transition to soft foods and then solid foods.

• Long-Term Diet: A high-protein, low-fat, and low-carbohydrate diet is essential to prevent nutritional deficiencies and ensure sustained weight loss.

• Meal Frequency: Patients are advised to eat smaller, more frequent meals to prevent overloading the digestive system and to ensure adequate nutrient absorption.

• Hydration: Adequate fluid intake is essential, but patients should avoid drinking fluids during meals to prevent overfilling the stomach pouch.

• Nutritional Supplements: Due to the malabsorptive nature of the surgery, patients will need to take lifetime vitamin and mineral supplements, including vitamin D, calcium, iron, B12, folic acid, and multivitamins to prevent deficiencies.

Potential Risks and Complications

While BPD is an effective weight-loss surgery, there are risks and potential complications to be aware of, including:

• Nutrient Deficiencies: Since a significant portion of the intestines is bypassed, patients may experience vitamin and mineral deficiencies that require lifelong supplementation.

• Protein Malnutrition: Patients who do not consume enough protein may develop protein malnutrition, leading to weight loss, muscle wasting, and other health problems.

• Dumping Syndrome: Some patients may experience symptoms such as nausea, vomiting, diarrhea, and sweating after consuming high-sugar or high-fat foods.

• Gallstones: Rapid weight loss can increase the risk of developing gallstones, which may require further treatment.

• Bowel Obstruction: A small risk of bowel obstruction exists due to the altered intestinal pathway.

• Leakage or Infection: Like all surgeries, BPD comes with the risk of infection, leakage, or complications at the surgical site.

Conclusion

Biliopancreatic diversion (BPD) is a highly effective bariatric surgery that offers significant and sustainable weight loss, along with improvement or resolution of obesity-related health conditions. It combines both restrictive and malabsorptive techniques to achieve substantial weight loss by reducing the stomach’s size and bypassing a portion of the intestines. However, BPD requires a lifelong commitment to dietary changes, vitamin and mineral supplementation, and regular follow-up care. If you’re considering BPD as a weight loss option, it’s important to consult with a qualified bariatric surgeon to determine if this procedure is right for you.