What is biliopancreatic diversion surgery?
Biliopancreatic diversion surgery is when sections of the stomach are removed (approximately 85% of the original stomach) to create a small pouch. The remaining small pouch then bypasses the upper part of the small intestines and is directly connected to the final part of the small intestine. Dr Ozmen performs this surgery laparoscopically (keyhole surgery) and under general anaesthetic.
How does biliopancreatic diversion surgery assist in weight loss?
There are two facets to this procedure that result in weight loss.
Firstly, your stomach has been reduced in size which restricts the amount of food you are able to intake.
Secondly, biliopancreatic diversion is a malabsorptive procedure. When performing this surgery Dr Ozmen leaves a common channel where the bile and pancreatic digestive juices meet and mix together before they enter into the colon. This means that most of the calories and nutrients are now routed more quickly into the colon instead of passing through the small intestines and are not absorbed as easily.
How much weight is generally lost?
There is greater weight loss achievable through biliopancreatic surgery than any other bariatric procedure available, however there are a number of contributing factors as to the amount of weight loss you will be able to achieve.
As a general rule you can expect to lose about 30-40% of your excess weight in around 6 months, and you can expect your excess weight loss to increase up to an average of 75% of in year 1. Some patients will lose less than 75% of excess weight and some patients may lose up to 80% of their excess weight. As your body adjusts your excess weight loss will stabilise to a long term weight loss reduction of about 70%.
The other advantage of this procedure is that you are less likely to regain weight because of the reduced ability to absorb ingested fat and starch.
What are the other health benefits (other than weight loss)?
As with all weight loss procedures, there are other significant health benefits that you will achieve from restoring your body to a more healthy weight. These benefits are listed throughout our website and have been identified and listed in worldwide studies and include the following health improvements:
- Improved self image and psychological benefits
- Remission of type 2 diabetes
- Decreased risk of stroke and improved heart health.
- Normal blood pressure and cholesterol levels
- Elimination of obstructive sleep apnoea
- Better joint health
- Improved fertility
- Reduced pregnancy complications
- Elimination of stress based urinary incontinence.
What are the risks and potential complications of biliopancreatic diversion surgery?
As with any surgical procedure, there are risks involved. Risks associated with this surgery will come under two categories:
- General surgical risk which is associated with any type of surgery.
Risks in this category include, but are not limited to, infection, post-op bleeding and blood clots. All surgery complication risks are also impacted and increased by other health conditions that include obesity, diabetes and cardiovascular disease as well as lifestyle habits like smoking.
- Risks specific to biliopancreatic diversion surgery.
Biliopancreatic diversion surgery is more complex than other bariatric procedures and is therefore not performed as often as Sleeve Gastrectomy or Roux-en-Y gastric bypass surgery. It is also considered higher risk surgery as your body has more difficulty absorbing food and nutrients.
Dr Ozmen will discuss with you in detail the risks of this type of procedure prior to your surgery as well as any possible complications and ongoing lifestyle impacts you may experience which can include:
- Dumping syndrome
- Incisional hernia
As this is a malabsorptive procedure, you will also need to take vitamin and mineral supplements for the rest of your life. This adds an ongoing financial burden associated with this type of bariatric surgery.
Should you experience ongoing difficulties and complications, it is important to note that biliopancreatic diversion is a reversible procedure.
Who qualifies for biliopancreatic diversion surgery?
Because of the complexity and the higher risks associated with biliopancreatic diversion procedures, Dr Ozmen will only recommend this surgery to patients who are categorised as super obese and have attempted and been unable to lose weight any other way.
Super obesity means you have a body mass index (BMI) of 50 or higher.
What is the cost?
Biliopancreatic diversion surgery is an elective procedure that in Australia is currently performed mainly in private hospitals. Some of the costs for the procedure may be covered by your private health insurance and you may also have the ability to access your superannuation funds for the cost of the surgery due to the recognised health benefits related to weight loss.
Please contact the Sydney GI Surgery team for an accurate assessment of the costs involved for a biliopancreatic diversion procedure.
Preparing for weight loss surgery
As with all bariatric procedures, to ensure the best possible outcome from your weight loss surgery, Dr Ozmen will commence you on a pre-operative low calorie diet. This is to allow your liver to shrink prior to your operation to make the surgery safer.
Dr Ozmen is highly specialised in bariatric surgery and is one of only a few surgeons in Sydney who is able to perform biliopancreatic diversion surgery laparoscopically (by keyhole) to minimise your recovery time.
Each patient’s recovery time will differ, and Dr Ozmen will discuss your individual risks with you prior to your surgery, however in general, recovery from this procedure will usually require between 2-3 days in hospital before returning home. Normal lifestyle activities can typically be resumed after 5-6 weeks, with full recovery anticipated in 3-6 months.
After your surgery you will be required to adopt a strict diet in the first 4 weeks following surgery that will consist mostly of soft foods and liquids to give your stomach a chance to recover. After this period, your diet will increase in consistency with the introduction of solid foods.
Life after biliopancreatic diversion surgery
The high rate of weight loss success of this procedure and the improved quality of life following surgery makes biliopancreatic diversion surgery a good option for people who are super obese and want to change their life.
One of the major benefits of this surgery, is that within one year once have fully recovered from your surgery, you will be able to eat normal size helpings, however you will need to avoid fatty and oily foods. The surgery is also reversible.
The disadvantages are that the surgery is higher risk compared to other weight loss procedures and you will need to add daily supplements of vitamins and minerals to maintain good health.
As with all surgical weight loss procedures, biliopancreatic diversion surgery should be considered as a tool for weight loss. Reaching and maintaining your desired weight loss goals will require your ongoing commitment to adopting lifestyle changes and habits that include healthy food choices and regular exercise. Without adopting lifestyle changes, the regain of weight is common after weight loss surgery.
As part of a best practice approach to stabilised weight loss, Dr Ozmen will provide access to dieticians who specialise in weight loss surgery after care and can assist you in adopting a healthy eating plan post surgery.