What is a Duodenal Switch?

What is the duodenal switch surgery? Is it like gastric bypass?

Doctor Answers 3

What is a duodenal switch

A duodenal switch is very much like a gastric bypass.  They both involve stapling the stomach to create a smaller pouch so you can eat less and feel full after a few bites.  They both involve an intestinal bypass, with the specific lengths bypassed determined by the individual preference of the surgeon performing the operation.  

The main difference between the two is that the gastric pouch stapled off in a gastric bypass is about the size an egg and is situated at the top of the stomach, while the remaining stomach is left in place to produce digestive juices that are brought downstream into the bypassed intestinal limb.  The duodenal switch creates a smaller stomach by utilizing the sleeve gastrectomy where the stomach is the size of a banana, but keep the valve intact so food can build up and keep you full rather than quickly empty out into the intestines.  The remaining stomach that is stapled off gets removed from the patient's body.  The intestinal bypass is performed after the stomach valve (called the pylorus).  

The duodenal switch can be relied on to help patients lose a bit more weight and resolve diabetes 

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Duodenal Switch - when to consider.

     The duodenal switch operation is best for the super obese patient (BMI>50) with significant metabolic issues such as diabetes and high cholesterol.  The DS is actually even better for placing diabetes in remission (98%) as compared to Bypass (85%). Also for patients that have hyperlipedemia, this can be a better option as compared to bypass. The DS offers the patient a more "normal" eating pattern as compare to bypass and less chance of marginal ulceration and virtually no dumping.  Patients with the DS experience two to three BM s per day and sometimes the frequency of bowel movements require revision surgery as compared to bypass where patients tend to be more constipated. In the correct patient this can be an excellent option for those seeking long term weight loss.

What is duodenal switch?

Duodenal switch is mainly a malabsorptive operation where most of the small intestine is bypassed so you don't absorb the calories you eat, but unfortunately you also don't absorb your vitamins and minerals and this procedure carries high rates of deficiencies in vitamins and minerals and protein. The gastric bypass is both restrictive and less malabsorptive.

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