Biliopancreatic Diverter Surgery is one of the methods developed for the treatment of obesity. This method was developed by the renowned Italian doctor Prof. Nicola Scopinaro in 1979. It is a groundbreaking procedure in the field of obesity surgery and offers a different perspective on this field.
What Is Biliopancreatic Diverter Surgery?
Biliopancreatic diverter surgery is essentially similar to gastric bypass. In this procedure, a portion of the patients’ stomachs and small intestines is bypassed. This allows patients to feel full with less food and reduces the absorption of consumed foods.
This method is preferred for the treatment of obesity-related diseases such as type 2 diabetes and hypertension. It is developed for patients who do not lose weight with diet and exercise and have a body mass index of 40 or higher.
How Is Biliopancreatic Diversion Surgery Performed?
Biliopancreatic diversion surgery is currently performed using minimally invasive laparoscopic surgery. This surgery consists of several stages. These stages are as follows:
- Patients are first placed under general anesthesia.
- If the patient’s condition is suitable, the surgery is performed using laparoscopic surgery.
- Four or five incisions are made in the abdominal area. The sizes of these incisions are between 0.5 cm and 1 cm.
- A medical camera is inserted through one of the incisions and directed to the surgical area. Medical instruments are inserted through the other incisions.
- The surgery is performed based on the images from the camera.
- In the surgery, a portion of the stomach is removed, approximately 90% of the stomach.
- The part of the stomach connected to the esophagus is left untouched, and a smaller new stomach is created.
- The bypassed small intestines are connected to the new stomach.
- A connection is created for the fluids from the gallbladder and pancreas to reach the other end of the small intestines.
The general steps in biliopancreatic diversion surgery are as described. When these steps are examined, gastric bypass surgery will come to mind immediately. This procedure is quite similar to gastric bypass. However, the most important difference between them is that in this method, the first and second parts of the small intestines are separated, resulting in a higher reduction in food absorption.
After this procedure, the consumed foods go directly to the second part of the small intestine without passing through the first part, which includes the duodenum and the jejunum.
Recovery Process After Biliopancreatic Diversion
Biliopancreatic diversion is a comprehensive procedure. It affects the stomach, duodenum, jejunum, and a portion of the small intestine. Even the gallbladder and pancreas start sending their fluids through a new path as part of the procedure.
The recovery process for such a comprehensive surgery is relatively longer. Since the surgery is performed laparoscopically, the incisions heal quickly, but a longer recovery period is required for the interventions in the digestive system.
During and after the surgery, leak checks are performed. It is crucial that there are no leaks in the stomach and the connected intestines. Patients stay in the hospital for 2-4 days for this reason. During this period, the presence of abdominal pain and high fever is indicative of a leak.
Dumping syndrome, which occurs due to the rapid emptying of the stomach, is another important detail after biliopancreatic diversion surgery. This syndrome is characterized by nausea, vomiting, and weakness.
After the procedure, patients are initially fed with liquids for the first month. Then, they gradually transition to pureed foods, finely textured soft foods, and finally, normal foods. It takes about 2-3 months for the diet to fully recover and return to normal.
Weight Loss After Biliopancreatic Diversion Surgery
After biliopancreatic diversion surgery, patients start to lose weight rapidly. Those who adhere to diet and exercise programs, follow doctor’s instructions, can lose up to around 40% of their excess weight.
To consider the procedure successful, patients are expected to lose 80% of their excess weight. The procedure’s significant reduction in stomach capacity and decreased absorption capacity of the intestines make it easier for patients to lose weight while making it challenging for them to meet their vitamin and mineral needs. Therefore, patients should include vitamin and mineral-rich foods in their diets. Additionally, vitamin and mineral supplements can be taken when necessary.
To ensure regular weight loss and a smooth recovery process, it is important for patients not to skip doctor appointments after biliopancreatic diversion surgery.