Biliopancreatic diversion

A biliopancreatic diversion is a surgery considered for severely overweight individuals to help them lose weight. The surgery is considered one of the most radical weight loss surgeries available and as such is normally considered for individuals with a body mass index of over fifty.

If patients have been unable to lose appropriate amounts of weight with conventional, conservative strategies including dieting, increasing activity levels and exercise this may pose a longer term health risk. Specifically, diabetes, heart and lung disorders are all far more common in severely overweight individuals.

A biliopancreatic diversion is an operation that is performed under general anaesthesia. Although the procedure can be performed as a keyhole (laparoscopic) procedure, in most cases surgeons prefer better visualisation and as such, it is performed by making an incision to the front of the abdomen. Once the surgical team have gained access to the stomach they create a smaller stomach pouch.

Furthermore, the tube that transfers the partially digested food from the stomach to be passed (small intestine) is cut and made shorter. This allows less time for nutrients to be absorbed. Together, the smaller stomach pouch and the shorter small intestine result in a reduction in calories being taken in by the body and weight loss.

There are some general risks and complications with any type of surgery which include:

• Anaesthetic risk
• Wound infection
• Blood clots (due to relative inactivity during recovery)
• Nausea and fatigue following the operation

There are also some more specific risks associated with operations aimed at achieving weight loss. These risks are greater with a biliopancreatic diversion than with any of the other procedures due to the complex nature of the surgery. Some risks include:

• Deep abdominal infection sometimes leading to sepsis
• Leakage of the stomach contents in to the abdominal cavity
• Osteoporosis
• Anaemia
• Mineral deficiencies

Recovery and progress after a biliopancreatic diversion

A biliopancreatic diversion operation is a significant undertaking. Patients will be required to stay in hospital for several days after this operation to monitor your health. In general, patients will need to stick to a liquid diet for two weeks immediately after the operation.

If complications do not arise, a biliopancreatic diversion operation is an extremely effective way of losing weight. Due to the restrictive effect the surgery places on calorific absorption the weight loss begins immediately after surgery. Some studies have indicated that medium to long term weight loss can be as high as seventy-five percent of excess weight.