Duodenal Switch: Advantages

Advantages:

  • A partial Gastrectomy of the stomach, along the greater curvature, results in effectively reducing the stomach capacity while maintaining the functionality of an unaltered stomach.

  • The remaining stomach typically holds between four and seven ounces. This allows for larger quantities of food to be consumed at a single sitting and reduces the necessity to eat many times per day.
  • The [[Pyloric Valve]] remains intact. This regulates the flow of digested and partially digested foods from the stomach into the small intestine. The significantly reduces the possibility of dumping syndrome, stoma closures, marginal blockages, and blockages.
  • The section of stomach removed, known as the greater curvature, is where the hormone Ghrelin is produced in largest quantities. Ghrelin is the hormone responsible for stimulating appetite. This results in greatly lowering cravings for food.
  • The greater curvature also is ‘home’ to the stomach’s largest concentration of acid producing tissue. By removing this section of the stomach the risk of ulcer formation is significantly reduced.
  • The DS keeps a portion of the duodenum in the food stream, attaching directly to the stomach and keeping the pylorus-duodenum pathway intact. This allows slightly more “normal” absorption of nutrients such as protein, calcium, iron, and B12 than some other surgery types.
  • Because the pyloris remains intact, DS patients can take NSAIDS as opposed to surgeries where the pyloric valve is removed forcing a strict ban on the use of NSAIDS.
  • The restructuring of the duodenum separates the path of food from the flow of pancreatic juices and bile until much further down in the digestive tract. This limits the absorption of both calories and some nutrients.
  • Once the intestinal paths are rejoined at a junction that begins the common channel, also referred to as the common loop, pancreatic juices and bile rejoin and mix with the food and limited absorption of fat occurs at this point. Because of the very short length of the common channel (usually between 75 and 150cm) it is common to see as little as 20% of the fat consumed actually absorbed by the body.
  • The diminished absorption of fats and calories from fat allows DS patients to eat foods that have a higher fat content without suffering the ill effects and may often exhibit cholesterol, triglyceride, and blood pressure readings consistent with those following low fat diets.
  • The DS allows a much broader range of foods to be eaten post surgery. Most patients can tolerate any foods they were able to consume prior to surgery; however, some experience difficulty eating breads, pasta, and rice in large quantities. Many DS patients have also related that they have developed an intolerance for lactose at least temporarily following their surgery. It is very rare for a DS patient to experience dumping as a result of eating foods high in sugar; though, some do not consider this an advantage.