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The biliopancreatic diversion with duodenal switch, duodenal switch, or DS weight loss is the most powerful of the weight loss procedures. The duodenal switch is performed by permanently removing a portion of the stomach. The new stomach is about the size and shape of a banana also known as a sleeve gastrectomy.

The duodenal switch promotes weight loss primarily through malabsorption. This is done by bypassing a large portion of the small intestine. This section of the small intestine where food and digestive enzymes meet is called the common limb. Following a duodenal switch, the common limb where nutrients and calories will primarily be digested and absorbed is about 3 feet long.


  1. Results in greater weight loss than gastric bypass, sleeve gastrectomy or gastric band, i.e. 60 – 70% percent excess weight loss or greater, at 5 year follow up
  2. Allows patients to eventually eat near “normal” size meals
  3. Reduces the absorption of fat by 70 percent or more
  4. Causes favorable changes in gut hormones to reduce appetite and improve satiety
  5. Is the most effective against diabetes compared to gastric bypass, sleeve gastrectomy or gastric band


  1. Has higher complication rates and risk for mortality than the gastric bypass, sleeve gastrectomy or gastric band
  2. Requires a longer hospital stay of 1-2 nights
  3. Has a greater potential to cause protein deficiencies and long-term deficiencies in a number of vitamin and minerals, i.e. iron, calcium, zinc, fat-soluble vitamins such as vitamin D
  4. Compliance with follow-up visits and care and strict adherence to dietary and vitamin supplementation guidelines are critical to avoiding serious complications from protein and certain vitamin deficiencies

Overall, duodenal switch weight loss surgery is very effective in helping patients lose weight and keep it off. As you consider the advantages and disadvantages of this bariatric procedure, it is important to remember that all weight loss surgeries involve some degree of risk. If you are interested in the Duodenal Switch procedure, the next step is to attend a weight loss surgery seminar to discuss your options with your bariatric surgeon. Your doctor can determine if you are a good candidate and will make sure you fully understand the lifestyle changes that will be required should you choose duodenal switch weight loss surgery. No matter which weight loss surgery is chosen, individuals need to change their lifestyle and learn to work with the surgery and their surgeon in order to be successful.