Biliopancreatic Diversion With Duodenal Switch: Before Your Surgery

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What is a biliopancreatic diversion with duodenal switch?

This surgery is done to make your stomach smaller. It also allows food to bypass part of the small intestine. This means you absorb fewer calories and lose weight.

You will be asleep during the surgery. Your surgery will be done in one of two ways. Open surgery is done through a large cut in the belly. This cut is called an incision. Laparoscopic surgery is done through several small incisions. The doctor uses small tools and a camera to guide the surgery.

The doctor will take out part of the stomach but leave the pylorus intact. The pylorus controls food drainage from the stomach. The pylorus is connected to a lower segment of the intestine. The upper part of the small intestine (the duodenum) is then connected to the lower part of the small intestine.

After the surgery, the food you eat will pass from your smaller stomach into the lower part of your small intestine.

The doctor will close the incision in your belly with stitches or staples. These will be removed 7 to 10 days after surgery, unless your doctor uses stitches that dissolve. The incision will leave a scar that fades with time.

Your stomach will be smaller than before. This means that you will get full more quickly when you eat. You will need to change the way you eat.

Your body will have a harder time taking in nutrients. So you will have to take extra vitamins and minerals.

You may stay in the hospital for 1 or more days after the surgery. Most people need 3 to 5 weeks before they can get back to their usual routine.

Before you have this surgery, be sure to discuss the risks and benefits with your doctor.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to follow a clear liquid diet for several days before surgery. Your doctor will tell you how to do this.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
    Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
    Do not shave the surgical site yourself.
    Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
    The area for surgery is often marked to make sure there are no errors.
    You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
    The surgery will take several hours.
    If you're having an open surgery, you may get an epidural. This is a tiny tube that puts pain medicine into your back in the area around your spinal cord.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.