Biliopancreatic Diversion with Duodenal Switch Complications

Comparison of Complication Rates Among Bariatric Procedures

The American Heart Association notes that Biliopancreatic Diversion with Duodenal Switch (BPD/DS) has higher rates of severe nutritional deficiencies, malabsorptive complications, and reoperations compared to other bariatric procedures 1, 2
BPD/DS is performed less frequently due to severe nutrient malabsorption and higher incidence of short- and long-term complications 1
Perioperative complications occur in 2-8% of BPD/DS cases, including mortality (<1%) and deep vein thrombosis/pulmonary embolism (0.4%) 3
Long-term complications of BPD/DS include anemia (13-20%), protein deficiency (0.3-3.0%), iron deficiency (17%), zinc deficiency (6%), neuropathy (0.4%), and vitamin D deficiency and elevated parathyroid hormone may exceed 40% 3
The American College of Cardiology reports that Roux-en-Y Gastric Bypass (RYGB) has perioperative complications, including major adverse outcomes in 4-5% of patients, with mortality (0.2%), deep vein thrombosis/pulmonary embolism (0.4%), and need for reoperation (3-5%) 3
Laparoscopic Adjustable Gastric Banding (LAGB) has perioperative complications, including major adverse outcomes (1%) and minor complications (3%) 3
Sleeve Gastrectomy (SG) is currently the most performed bariatric procedure worldwide, with lower rates of nutritional deficiencies compared to RYGB and BPD/DS 1

BPD/DS creates profound nutritional malabsorption by bypassing significant portions of the small intestine 1
Patients undergoing BPD/DS require lifelong nutritional supplementation and monitoring 5

Extremely high BMI, limited mobility, history of deep vein thrombosis or pulmonary embolism, and history of obstructive sleep apnea are risk factors for complications across bariatric procedures 3
Age >65 years is associated with a 90-day mortality rate of 1.3% and an overall complication rate of 20.1% 2