Biliopancreatic diversion is a surgical procedure which is performed for the purpose of helping the patient lose weight. It is a form of weight loss surgery, also known as bariatic surgery, in which weight loss is induced by limiting food intake and also reducing the amount of food which a patient can digest. This surgery is only performed when a patient cannot lose weight by other means, and when the patient is experiencing medical complications or personal hardship as a result of his or her high weight.
This procedure is also known as a Scopinaro procedure, after the surgeon who developed it. It is performed under full anesthesia in an operating room, usually by a bariatric surgeon who works with the assistance of a surgery team which includes an anesthesiologist and a team of nurses. Some surgeons perform the procedure laparoscopically through small incisions in the abdomen, while others use a large incision in the abdomen for an open procedure.
In a basic biliopancreatic diversion part of the stomach is removed and an anastamosis is made with the small intestine. Rather than joining the stomach to the top of the small intestine, however, the surgeon bypasses part of the small intestine. This is done to reduce the amount of digestion which takes place in the small intestine, which limits the calories the patient can absorb from food. In a biliopancreatic diversion with duodenal switch, the duodenum is left intact because less of the stomach is removed and a join is also made lower down with the small intestine.
There are a number of risks to their procedure. Anesthesia can be dangerous, especially for overweight patients, and the patient also runs the risk of developing an infection if the surgical site is not properly cared for. After the surgery, the patient has a lifelong risk of malnutrition and must meet with a nutritionist to establish a diet which will ensure that the patient is not deprived of nutrients. Some patients develop ulcers after a biliopancreatic diversion and others experience dumping syndrome, in which food moves too quickly through the intestinal tract, causing symptoms like nausea, dizziness, and vomiting.
A biliopancreatic diversion with duodenal switch carries less risk of long term complications than the basic procedure. However, some surgeons have other surgeries they prefer. Patients who are candidates for bariatric surgery can discuss their options with the surgeon to determine the most appropriate choice for their needs. Patients should ask the surgeon to discuss risks and aftercare requirements in detail so that they can make an informed choice.
