biliopancreatic diversion


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biliopancreatic diversion

a surgical treatment for morbid obesity consisting of resection of the distal two thirds of the stomach and attachment of the ileum to the proximal stomach. The duodenum and jejunum are bypassed and empty their secretions into the distal ileum through a new anastomosis. Also called biliopancreatic bypass.

biliopancreatic diversion

(bĭl″ē-ō-păn″krē-ăt′ĭk) [″ + ″],

BPD

A bariatric surgical treatment for obesity in which most of the stomach is removed. The remaining proximal pouch is anastomosed to the distal ileum bypassing the duodenum and proximal small intestine. The proximal small intestinal segment is anastomosed to the ileum distal to the gastroileal anastomosis. The procedure restricts the intake of nutrients and causes malabsorption, both of which lead to weight loss. Successful procedures result in sustained weight loss of about 25% of body weight, a result as good as any other surgical treatment for overweight. Common complications of the procedure include iron-deficiency anemia, deficiencies in the absorption of vitamins A, D, E, and K and the minerals calcium and magnesium, gradual bone loss, foul-smelling stools, and failure of surgical anastomoses. The operation takes more time to perform than other bariatric surgeries and tends to have more immediate postoperative complications. The procedure is infrequently performed because of its many complications.
References in periodicals archive ?
Laparoscopic vertical sleave gastrectomy: It was first introduced in super obese patients as an initial procedure of the biliopancreatic diversion with duodenal switch.
Both the gastric bypass and biliopancreatic diversion procedures were performed by independent surgical teams.
The greatest decrease in mean BMI (from 51 to 32) was seen in those who had a biliopancreatic diversion.
The biliopancreatic diversion (BPD), the most powerful and drastic of the bariatric surgeries available, rarely is performed in the United States due to the complications of the surgery and the development of a hybrid surgery, the duodenal switch (DS).
The list of nationally-covered procedures now includes open and laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and open and laparoscopic biliopancreatic diversion with duodenal switch.
6 underwent biliopancreatic diversion, 14 laparoscopically.
Ninety percent of the patients had the most common type of weight loss surgery-gastric bypass-and the other patients had either vertical banded gastroplasty (also called gastric band surgery) or biliopancreatic diversion.
In its 2006 national coverage decision for bariatric surgery in morbid obesity, CMS said that Medicare would cover three procedures--open and laparoscopic Roux-en-Y gastric bypass surgery, open and laparoscopic biliopancreatic diversion with duodenal switch, and laparoscopic adjustable gastric banding-for beneficiaries who have a BMI over 35, have at least one comorbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity.
That decision said that Medicare would cover only three procedures--open and laparoscopic Roux-en-Y gastric bypass surgery, open and laparoscopic biliopancreatic diversion with duodenal switch, and laparoscopic adjustable gastric banding--for beneficiaries who have a BMI greater than 35, have at least one comorbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity.
There are 4 main categories of procedures: malabsorptive (eg, biliopancreatic diversion, duodenal switch), malabsorptive/restrictive (eg, Roux-en-Y gastric bypass), restrictive (eg, vertical banded gastroplasty, gastric banding), and neither malabsorptive nor restrictive (eg, gastric or vagal pacing).
LAP-BAND, Gastric Bypass and Biliopancreatic Diversion Were Determined at a "Moderate to High Confidence" Level to Produce a Clinical Net Health Benefit in Morbidly Obese Patients
It said Medicare would cover three procedures--open and laparoscopic Roux-en-Y gastric bypass surgery, open and laparoscopic biliopancreatic diversion with duodenal switch, and laparoscopic adjustable gastric banding--for beneficiaries with a BMI greater than 35, at least one comorbidity related to obesity, and who had been previously unsuccessful with medical treatment for obesity.