Duodenal Switch

  • Sébastien Blaye-Felice
  • Stéfane Lebel
  • Simon Marceau
  • François Julien
  • Laurent Biertho


The classical biliopancreatic diversion (BPD) was first described in 1979 by Nicola Scopinaro. The goal of the procedure was to preserve the excellent long-term metabolic outcomes from the malabsorptive component of the jejunoileal bypass (JIB), while decreasing gastrointestinal side effects and risks of liver and kidney failures, which led to the abandon of the JIB a long time ago. In BPD surgery, the distal two-third of the stomach are removed, to obtain a mild gastric restriction, and the gastric pouch is connected to the distal ileum, creating a 250-cm alimentary tract and a 50-cm common channel. In the late 1980s, Hess and Marceau modified the type of gastrectomy to perform a large “sleeve gastrectomy, SG,” keeping the same length of strict alimentary limb and common channel but connecting the alimentary limb to the first duodenum (“duodenal switch, BPD-DS”). This modification was based on animal study by DeMeester et al., who originally described duodenal switch procedure for the treatment of bile gastritis. The length of the common channel was later increased to 100 cm to decrease malabsorption and side effects.


Metabolic surgery Bariatric surgery Biliopancreatic diversion Duodenal switch Surgical technique 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sébastien Blaye-Felice
    • 1
  • Stéfane Lebel
    • 1
  • Simon Marceau
    • 1
  • François Julien
    • 1
  • Laurent Biertho
    • 1
  1. 1.Department of Bariatric and General SurgeryInstitut Universitaire de Cardiologie et Pneumologie de Québec – Université LavalQuebecCanada

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