Duodenal Switch

What is 'duodenal switch' bypass surgery?

Duodenal switch operation is where we, again, reroute the intestines, in a different way than we do with the gastric bypass, and we also reduce the size of the stomach. And a large portion of the small intestine is bypassed so it's called a distal bypass.

Why is the duodenal switch used over other gastric bypass methods?

The duodenal switch is used by several surgeons because of the success rate. They feel it works better than the gastric bypass, and from the literature I've read, that's true. I don't personally do the duodenal switch, because I think the lifestyle changes in the patients are worse than with the gastric bypass, and it doesn't balance off the success rate of the gastric bypass. I am not saying in any way that it is a bad procedure. I think patients need to know the information, get well informed, and then choose if that's what they want. And I have referred patients who say that's what they want, to another surgeon who does that type of procedure.

Can duodenal switch be dangerous or fatal?

A duodenal switch, like any operation, has a mortality rate and a morbidity rate. I don't know the exact numbers but it's probably similar to the gastric bypass if not slightly higher than the gastric bypass but I don't think tremendously. We are talking about probably four patients in a thousand, maybe five patients in a thousand that might die from duodenal switch and the complication rates of infection, bleeding, pulmonary emboli probably equal to the gastric bypass.

What are the side effects of duodenal switch bypass surgery?

Side effects of the duodenal switch are more than the gastric bypass. So everything we talked about with gastric bypass side effects, the duodenal switch would have. But also, since it's a distal operation, they have more malabsorption. So there's more malabsorption of protein. And since the fats and the protein pass through the system faster, there's a lot of diarrhea, it can be very smelly diarrhea, and a body odor that a lot of the patients who have come to me who have had it, we need sometimes to reverse part of it. It can be restrictive in their lifestyle.

How fast can I lose weight after duodenal switch bypass surgery?

Patients lose weight similar to the gastric bypass, or faster than with the gastric bypass. So, with gastric bypass I usually expect patients to stabilize around twelve months, between nine and twelve months. If the patient is very heavy, about eight teen months. And again, although I'm not an expert with the duodenal switch, it occurs a couple of months faster than that.