Duodenal Switch

Initially developed to reduce the rate of marginal ulcers after BPD, so it's somewhat similar to that operation.

• Common channel 100cm and the entire alimentary tract is 250cm
• But instead of a distal hemigastrectomy, a sleeve gastrectomy is performed

Technique

• Sleeve gastrectomy
• Appendicectomy
• Divide duodenum 2cm beyond pylorus
• Divide ileum 250cm proximal to ICV and create end-to-side duodenoileostomy (antecolic) - can be hand-sewn or stapled
• 100cm common channel

Complications

• See BPD page