Duodenal Switch: Comparison to Other Surgeries

To fully understand and compare surgeries, one must understand the surgical process first. With duodenal switch surgery, nearly 70% of the stomach is removed and the digestive tract is altered. Two separate pathways are created to take food from the stomach to a common channel and the other pathway, the biliopancreatic loop, carries bile from the liver to the same channel. The common channel is a portion of the small intestine.

Benefits or Advantages of Duodenal Switch

Both gastric bypass and duodenal switch use combination methods during their surgeries. However, duodenal switch sees much higher weight loss rates, almost 50% more than gastric bypass after one year and two year post-op benchmarks. In a 10 year period, gastric bypass patients see 25% overall weight loss, while duodenal switch patients see 60-70% in just 8 years.

According to various studies, the surgery has a 98% or higher cure rate for Type 2 diabetes. This occurs almost immediately following surgery due to the metabolic effect from the switch of the intestine and its tract. The surgery also cures 92% of sleep apnea patients. Unlike Roux-en-y gastric bypass patients, DS patients do not experience dumping syndrome symptoms because of the preservation of the pyloric valve between the stomach and small intestine.
Also, compared to gastric sleeve, gastric bypass and other bariatric surgeries, post-op diet for duodenal switch patients is more normal and tolerated. Also, the malabsorptive component of the surgery is fully reversible unlike other surgeries that are permanent. Also U.S. News Health found that duodenal switch is more successful at maintaining weight loss then gastric bypass surgery.

Also, because of the preservation of the pyloric valve, many complications associated with gastric bypass surgery are avoided.

Disadvantages or Cons

While risks early on are higher with duodenal switch than any other weight loss surgery, the complication rate is low compared to those initial risks. Also, the duodenal switch surgery takes on average 20 minutes longer to perform and is associated with a longer hospital stay (3-5 days versus 2-3). Duodenal switch patients also typically undergo open surgery associated with a longer recovery time while gastric bypass and sleeve patients had laparoscopic surgery.

Also, because of rapid weight loss, many patients experience gallstone post-op. Because of this increased risk, many surgeons suggest removing the gallbladder during surgery as a preventative measure, which furthers extends the recovery process.

Duodenal switch patients also have higher occurrence of diarrhea or loose, frequent bowel movements after surgery as well as foul-smelling gas and frequent flatulence. Both of these things can be resolved with a low-carb diet.

While the restrictive portion of the surgery isn’t reversible, some duodenal switch patients see expansion in their stomach area overtime. This makes a reversal from stretching occur, which may increase GERD symptoms in the future. This is seen in duodenal switch surgery patients only.

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