Weight Loss Operations: Duodenal Switch

By WLR Dietitian

Juliette Kellow BSc RD

This is a variation of the bilopancreatic diversion. A large portion of the stomach is removed by a sleeve gastrectomy.

At the base of the stomach, a small section of the small intestine (the duodenum) is left behind, but the remainder is cut. The lower half of the small intestine is then joined to this small piece of remaining duodenum. As with the bilopancreatic diversion, bile and pancreatic juices are redirected to the lower part of the small intestine.

The operation can be performed by keyhole or regular surgery but it’s extremely complex and can take up to seven hours to complete, and requires 5-6 days in hospital.

This operation is linked with the greatest weight losses – after two years, 80 percent of people reach a normal weight – but it’s also one of the most risky operations with 1 in 100 people dying from surgery.

It also has unpleasant side effects including wind and diarrhoea caused by the malabsorption of fat, although eating a low-fat diet can help to limit this.

Nutrient deficiencies, including protein, iron, zinc, and the fat-soluble vitamins A, D, E and K, are also more likely and can lead to severe malnutrition. Supplements therefore need to be taken for the rest of life, together with a diet that contains twice as much protein as normal.

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