Duodenal Switch Surgery (BPD-DS)

Advanced weight loss surgery for severe obesity 

Duodenal switch surgery, also called biliopancreatic diversion with duodenal switch (BPD-DS), is a bariatric surgery that changes the stomach and small intestine to help you lose weight. It helps you feel full sooner and reduces how many calories and nutrients your body absorbs. 

This procedure can lead to greater weight loss than gastric bypass or gastric sleeve alone and may improve serious health conditions linked to obesity, such as type 2 diabetes, sleep apnea and high blood pressure. 

How does duodenal switch surgery work? 

Duodenal switch surgery is usually performed laparoscopically, using small incisions and special tools to support a faster recovery. 

The surgery has two parts:

1. Sleeve gastrectomy: A portion of the stomach is removed, leaving a smaller, sleeve-shaped stomach. You feel full faster and eat smaller portions.
2. Intestinal bypass: The small intestine is rerouted so food travels a much shorter path. 

This lowers calorie and nutrient absorption, which increases weight loss. After surgery, food travels through about half of the intestine it once did. This helps support long-term weight management. 

Who should consider duodenal switch surgery? 

This procedure is most often recommended for people who: 

• Have a body mass index (BMI) of 50 or higher 
• Have a BMI of 40 or higher with serious medical conditions such as: 
  • Type 2 diabetes 
  • Sleep apnea 
  • High blood pressure or cholesterol 
  • Nonalcoholic fatty liver disease 

Use a BMI calculator to see whether you may be a candidate.  

Your bariatric provider will evaluate your health history, lifestyle needs and weight-loss goals to determine whether duodenal switch is the best option for you. 

Benefits of duodenal switch surgery 

• More weight loss compared to many other bariatric surgeries 
• Improved blood sugar control, often helping reduce or eliminate diabetes medication 
• Lower risk of dumping syndrome, since the pylorus (stomach valve) remains 
• Ability to tolerate more normal food portions than some other procedures 

Many patients experience improvements in quality of life, mobility and overall health. 

Risks and important considerations 

Because the small intestine absorbs fewer nutrients after surgery, lifelong monitoring and vitamin supplementation are required. 

Potential risks include: 

• Vitamin and mineral deficiencies (protein, iron, calcium, vitamins A, D, E, K and B-12) 
• Digestive changes such as bloating, diarrhea or gas 
• Gallstones or gallbladder disease 
• Higher complication risk in people who smoke - smoking must be stopped before surgery 
• General surgical risks such as bleeding or infection 

Your care team will help track nutrient levels and support you in preventing complications. 

Life after duodenal switch surgery 

Weight loss continues over time when paired with healthy routines. You will receive guidance and support from our bariatric team, including: 

• A personalized eating plan from a registered dietitian 
• Regular medical follow-ups and bloodwork 
• Exercise and activity recommendations 
• Behavioral health support 
• Optional support groups before and after surgery 

Together, we focus on your long-term success and well-being. 

Why choose Banner Health for weight loss surgery? 

Bariatric surgery is a lifelong journey - and we support you through every step. 

Our multidisciplinary team includes: 

• Bariatric surgeons 
• Obesity medicine specialists 
• Dietitians 
• Behavioral health professionals 
• Nurses and care coordinators 
• Cardiologists, pulmonologists and sleep specialists when needed 

Banner Health is accredited as a Bariatric Center of Excellence by the American Society for Metabolic and Bariatric Surgery, which recognizes our high standards of patient safety and outcomes. 

Take the next step 

If you believe duodenal switch surgery might be right for you: 

Find out if you’re a candidate. 

Watch our free informational video.