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32 Laparoscopic Malabsorptive Procedures: Technique of Duodenal Switch

  • Giovanni DapriEmail author
  • Guy-Bernard Cadière
  • Jacques Himpens
Chapter

Abstract

Biliopancreatic diversion with duodenal switch is primarily a malabsorptive procedure. It consists of a combination of sleeve gastrectomy and biliopancreatic diversion (Obes Surg 8, 267–82, 1998; World J Surg 22, 947–54, 1998), and it can be performed in two steps (Surg Obes Relat Dis 7, 703–8, 2011). A Roux-en-Y limb is anastomosed to the first part of the duodenum at one end and to the transected small bowel some 75–100 cm proximal to the ileocecal valve at its other end. The mechanism of weight loss after duodenal switch is double:
  1. 1.

    Sleeve gastrectomy ensures restriction in the amount of calories taken by the mouth.

     
  2. 2.

    The functional shortening capacity of the small bowel reduces the absorption capacity of the latter since the exchange surface is smaller. Moreover fat can only be digested once the biliary and pancreatic juices are mixed with the food, which obviously occurs only quite distally. Different types of laparoscopic duodenoileostomy and jejunoileostomy are described in this chapter. The chapter is finally written to allow the reader to perform the laparoscopic duodenal switch step by step.

     

Keywords

Duodenal switch Biliopancreatic diversion Sleeve gastrectomy Laparoscopy Technique 

Supplementary material

Video 1

Technique of duodenal switch (MPG 144230 kb)

References

  1. 1.
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  2. 2.
    Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22:947–54.CrossRefPubMedGoogle Scholar
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    Dapri G, Cadière GB, Himpens J. Superobese and super super-obese patients: 2-step laparoscopic duodenal switch. Surg Obes Relat Dis. 2011;7:703–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Giovanni Dapri
    • 1
    Email author
  • Guy-Bernard Cadière
    • 1
  • Jacques Himpens
    • 1
  1. 1.Department of Gastrointestinal SurgeryEuropean School of Laparoscopic SurgeryBrusselsBelgium

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