Biliopancreatic Diversion: Procedure, Recovery, Cost, Risk & Complication

Biliopancreatic diversion surgery is a type of gastric bypass surgery that is not commonly performed on people, as it is more complicated and risky than the other gastric bypass procedures. A biliopancreatic diversion changes the normal process of digestion and allows food to bypass part of the small intestine which enables your body to absorb fewer calories. A common channel remains in which bile mixes with other pancreatic digestive juices before entering the colon. During surgery, a large portion of the stomach is cut out and removed to create a smaller stomach pouch, and then a part of the digestive system is re-routed so that food can bypass part of the small intestine. There are two types of biliopancreatic diversion surgeries: a biliopancreatic diversion and a biliopancreatic diversion with duodenal switch.

Because of the risks, this surgery is for people who are more than severely obese with a BMI of 50 or higher. It is done on people who want to lose weight but haven't been able to any other way - diet, exercise or medicine and this is creating serious health problems for them. In addition, biliopancreatic diversion patients should be prepared to make the necessary lifestyle changes that are required of bariatric surgery patients. This includes a commitment to a healthy lifestyle.

Pre Procedure

This surgery is a lot more complicated than other gastric bypass surgeries. There are a few pre-procedures you need to follow to ensure you are prepared for the actual surgery :

• Inform your doctor about all medications and natural health products you take. Follow his instructions on whether or not to continue taking these medications before surgery.
• If you take any blood thinners like clopidrogel, warfarin or aspirin be sure to talk to your doctor about continuing to take these medicines before surgery .
• You will be asked to take a bath before surgery but not to apply any lotions, deodrants, perfumes or nail polish. Also you should not wear any jewellery, piercings or contact lenses.
• You may be asked to follow a complete liquid diet for several days before the surgery. Follow your doctor’s instructions.

During Procedure

At the time of surgery, the area of surgery is often marked to avoid any errors. You will be administered with anaesthesia and will be asleep during the during the procedure. During the surgery a part of stomach will be cut out and removed. The remaining half will be connected to the lower portion of the small intestine. In the biliopancreatic diversion surgery with duodenal switch, an entirely different part of the stomach gets removed and the doctor leaves the pylorus intact. The pylorus is a valve that controls and coordinates food drainage from the stomach. These are done by making a large cut in the belly or by making a small cut and using small tools and a camera to guide the surgery.

Post Procedure

You may need to stay in the hospital for 1 or more days after the surgery. The doctor will close the incision in your belly with staples or stitches. These will be removed 7 to 10 days after surgery, unless your doctor uses stitches that can dissolve. The incision will leave a scar that fades with time. You may take 3 to 5 weeks before you can get back to your usual routine. You will be given more specific instructions about your diet, exercise, and recovering from your surgery by your doctor.

There are many risks and complications involved with biliopancreatic diversion surgery including dumping syndrome, diarrhoea, nausea, shakiness, faintness, deficiency of iron, calcium, magnesium or vitamin b12, infection, stomach leakage into the abdominal cavity, peritonitis, deep being thrombosis, pulmonary embolism, gallstones, anaemia, osteoporosis, irregular bowel movements, and constipation. After the surgery you have to be careful about your diet. Your body will have difficulty in absorbing nutrients so you will have to reply on vitamin and mineral supplements.

Depending on how the surgery was done, you'll have to watch your activity during recovery. If you have had open surgery, avoid lifting heavy weights or doing strenuous exercise. In this case, you will probably be able to return to your normal routine in 4 to 6 weeks.

Your doctor will give you specific instructions about what to eat after the surgery. For about the first month after surgery, you should only consume amounts of soft foods and liquids while you are healing. It is important to try to sip water throughout the day to avoid dehydration.

Biliopancreatic diversion surgery typically ranges from $15,000 to $25,000. People who have this surgery must take vitamin and mineral supplements for the rest of their lives, which can be expensive.