Biliopancreatic Diversion (Scopinaro) and Duodenal Switch
With these two procedures a portion of the stomach is removed. The small bowel is divided and the last section of the intestine is connected to the remaining stomach, which means that the majority of food eaten is expelled as waste and not absorbed as energy.
With the Duodenal Switch, a sleeve gastrectomy is performed first then the lower section of small bowel is connected to the duodenum. This creates an elementary loop of 200cm, a biliopancreatic loop of 200cm and a common limb of 100cm.
Weight loss after either of these operations is slightly superior to that after a gastric bypass.
These operations are more complex and time consuming than other procedures, which makes them more expensive.
The risk of complications is also the highest with these operations. Patients are more likely to develop nutritional deficiencies especially if they don’t follow the postoperative instructions.
These two operations should never be performed on patients who suffer from inflammatory bowel disease such as Crohn’s disease or Ulcerative Colitis.