The Increasing Incidence of the Biliopancreatic Diversion with Duodenal Switch as a Surgical Weight Loss Option: Implications for Nursing Care

Over the last 20 years, the rate of obesity in the United States has climbed to more than 33%. Obesity has been linked with comorbidities such as diabetes, hypertension, sleep apnea, hyperlipidemia, certain cancers, gastroesophageal reflux disease, arthritis, stoke, and heart disease. Bariatric surgery has proven to be an effective option to treat the disease of obesity and decrease, or even resolve, the patient's comorbid problems. Current surgical options include: laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and the biliopancreatic diversion with duodenal switch. While it may be the least known and utilized, the biliopancreatic diversion with duodenal switch (BPD/DS) is proving to be an effective surgical option for the super morbidly obese (body mass index greater than 50). Research is now showing that patients in this category benefit from the BPD/DS due to superior weight loss, greater metabolic disease resolution, and lowest weight regain rate when compared to other weight loss procedures. As this surgery becomes more prevalent, it is essential to be knowledgeable of the anatomy of this surgical option. Understanding the anatomical changes created by this surgery will help the nurse anticipate any potential immediate complications, provide education about self-care on discharge, and highlight the importance of long-term follow-up with the patient's bariatric team.