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		Obesity
		Gastric Band surgery
		Body Mass Index
		Contemplating Surgery
		Gastric Bypass
		Am I a candidate?
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Home Obesity Bilio Pancreatic Diversion BPD

Bilio Pancreatic Diversion BPD

Laparoscopic Adjustable Gastric Banding :: Gastric Bypass

These operations combines removal or exclusion of 2/3rds of the stomach along with a long
intestinal bypass which significantly reduces the absorption of fat. The capacity to eat is greater
than with the other operations, and the eventual weight loss is the best of all the operations but
if fatty foods are overeaten e.g. a hamburger and fries then diarrhoea and foul flatus will result.

Advantages:

Greater stomach capacity (200-250 mls) therefore can eat a small main meal instead of
an entrée portion.
Best weight loss of all techniques 70-90% EWL over 2yrs
Weight loss is well maintained
Adjustable and partially reversible, but only by further surgery.
A very good option for revision if other techniques have failed.

Disadvantages:

Open operation ( usually), therefore greater operative risks e.g infection, Bowel leak, Clots
to legs and lungs wound infection and hernia, chest infection. Risk of Death 1:200
Malabsorbtion to some minerals vitamins and Protein . Patients must commit to taking
lifelong supplements of the fat soluble vitamins ( A D E K ) Calcium and sometimes Iron.
Risk of deficiency state e.g. Iron deficiency anaemia or osteoporosis if supplements not
taken
Take longer to recover ( 6-8 weeks off work)
Requires removal of Gall bladder because of high incidence of stone formation
Increased stool frequency 2-4/day
Flatulance if fatty foods eaten

Sometimes it is offered to patients as part of a two stage Bypass operation particularly if they are
super obese ( BMI>60) because it allows good weight loss until the patient gets down to a safe
weight and the more radical bypass can then be offered laparoscopically when they are at a safer
weight.

The residual stomach capacity is about 200mls so a generous entree should be possible.

The weight loss seems to be of the same order as a lap band ( 50-60% EWL) over two years
but it is not adjustable.

It might also be a good option if patients have a problem with their lap band requiring revision,
have already lost a lot of weight and don't want a full bypass.