BPD and BPD-DS Concerns and Results

In fact, despite the complexity of the operation (which is more apparent than real), its perceived operative risk ( which is on the contrary probably even lower than operations such as sleeve gastrectomy) and the concerns regarding late metabolic sequelae (which can be extremely severe, but, with an adequate and in reality not particularly close follow-up are also extremely infrequent), biliopancreatic diversion with or without duodenal switch represents a formidable weapon in the most challenging cases, such as superobesity, uncontrolled metabolic syndrome, especially insulin-dependent diabetes type 2, and revisional surgery, in which it yields results that are far superior to those of any other bariatric operation. For these reasons, we believe that this operation should be in the armamentarium of every bariatric surgeon, to the point that no bariatric surgeon should be defined as such if he/she is not familiar with BPD and its patho-physiology.