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Biliopancreatic diversion (BPD) 
is a bariatric surgery

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for the treatment of obesity.

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It involves removal 
of part of the stomach

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to restrict how much food 
the stomach can hold,

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along with diverting the GI tract

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beyond some of the small intestine

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so fewer calories are absorbed.

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It is referred to as 
a malabsorptive procedure

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because the digested food 
from the stomach bypasses

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the first two segments 
of the small intestine,

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the duodenum and the jejunum,

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significantly decreasing 
absorption of nutrients,

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which helps with weight loss.

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Disease overview.

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Obesity is a chronic condition in which,

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there is an excessive accumulation 
of fat in the body.

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Obesity is defined as 
a body mass index (BMI) of 30 to 34.9

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and extreme or morbid obesity

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is defined by a BMI
of 40 or more.

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When a person's BMI is 50 or higher,

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it is referred to as super obesity.

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Obesity is a global problem,

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affecting people 
of almost all age groups,

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and is associated with 
a greatly increased risk

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of cardiac problems, diabetes, 
high blood pressure,

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breathing difficulties 
and diseases such as cancer.

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Indications.

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Due to the associated risks, 
biliopancreatic diversion surgery

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is usually only indicated 
for people who are super obese

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with a BMI of 50 or more

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that have not been able 
to lose weight

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with diet, exercise or medications,

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and are experiencing 
serious health problems.

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Surgery.

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The BPD surgery can be performed

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by open or laparoscopic techniques.

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In the open method, 
a large incision is made in your abdomen.

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The laparoscopic method is performed

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through 4 to 5 small incisions.

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A laparoscope, 
a thin fiber-optic tube,

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with a light and camera 
attached to the end,

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is inserted through one incision 
to view the internal organs.

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The camera allows your surgeon

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to clearly view 
the operating site on a monitor.

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Surgical instruments are inserted

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through the other tiny incisions 
to perform the surgery.

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In BPD surgery, 
the lower portion of the stomach is removed.

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The remaining part of the stomach

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is then attached to the ileum,

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the final segment 
of the small intestine,

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bypassing the first two portions 
of the small intestine.

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The incisions are closed 
upon completion.

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Postoperative care.

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Your doctor will prescribe 
pain relieving medications

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to keep you comfortable.

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You will be given instructions 
to follow

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regarding wound care, 
diet and activity such as

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keep the incision area 
clean and dry,

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avoid strenuous exercises 
and lifting heavy weights,

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for the first month 
after the procedure,

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eat only small amounts 
of soft foods.

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sip water throughout the day 
to prevent dehydration,

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follow the diet regimen 
given to you by the dietician,

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you will require

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daily vitamin and mineral supplementation 
for life.

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Risks and complications.

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As with any surgery,

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there are potential risks 
and complications involved.

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The risks 
associated with BPD surgery include

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problems associated with anesthesia,

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blood loss, infection, anemia,

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deep vein thrombosis 
(blood clot in the leg),

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gallstones and osteoporosis.

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A major complication of BPD surgery 
is dumping syndrome,

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a condition, 
in which nausea and diarrhea can occur

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after ingestion of 
highly refined and high-calorie foods.

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Biliopancreatic diversion or BPD

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is a common weight loss surgery 
to treat the super obese.

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The goal of surgery 
is to lose large amounts of weight

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by making you feel full 
more quickly

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with less amount of food,

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thereby limiting your calorie intake.

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Success is possible

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when patients commit 
to changing their lifestyle habits

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and have regular 
follow-up doctor visits

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for the rest of their life.