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Duodenal Switch

The duodenal switch, also known as the biliopancreatic diversion with duodenal switch or DS for short, is a complex and less commonly performed procedure. At our practice, we typically recommend the duodenal switch for our heavier patients. The duodenal switch is a combination of the gastric sleeve and gastric bypass and is non-reversible. 

How it Works

In performing the duodenal switch, the surgeon creates a sleeve gastrectomy by removing a significant portion of the stomach. The surgeon will then divide the small intestine just beyond the stomach as well as about 75% downstream. The lower portion of the intestine is connected to the stomach while the upper portion is reconnect further downstream.

This results in food traveling down one path and the digestive juices traveling down another. The food and digestive juices will meet up again approximately 75% further downstream. This results in significant malabsorption. 

This operation is not only shrinking the stomach size but is also shortening the small intestine by about 75%. This results in smaller portions of food consumed and the faster movement of food through your digestive system.

The duodenal switch takes about 3 hours to perform and patients can expect to stay at the hospital for up to 2 days after surgery. Depending on the type of work performed, patients will be able to return to work within 2 to 4 weeks from surgery.  


Patients who have the duodenal switch can expect to lose 80 to 100% of their excess body weight within the first year.
*Excess body weight is the percentage of how much weight was lost based on how much you have or want to lose.
Improvement or resolution of serious medical conditions
Long term cost savings as a result of reduced medical care
Improvement in overall health and quality of life


Before considering any surgical procedure, you should be familiar with the potential risks.
Minor complications that uncommon and can be managed fairly easily: 
  • Minor wound or skin infection
  • Loose/excess skin
  • Vomiting or nausea
  • Acid reflux (heartburn)
  • Changes in bowel habits like diarrhea, bloating, cramping, or gas
  • Development of gallstones or gallbladder disease
  • Nutritional deficiencies
Major complications, that could result in re-operation: 
  • Internal Bleeding
  • Intestinal obstruction
  • Blood clots in the legs or lungs
  • Internal hernia
  • Perforation of stomach/intestine or leakage