Hawasli & Associates
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For Appointments586-774-8811

For Appointments586-774-8811

Bariatric Program586-771-7220

Bariatric Program586-771-7220

  • Abdelkader Hawasli, MD.

    Dr. Hawasli is board certified in general surgery since 1986. He is the director of Laparoscopic Surgery and the Minimally Invasive Surgery...

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    Abdelkader Hawasli, MD.
  • Ahmed Meguid, MD

    Dr. Meguid is board certified by the American Board of Surgery. He has done advanced training in Laparoscopic, robotic and minimally invasive surgery...

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    Ahmed Meguid, MD
  • John E. Boccaccio, MD

    John E. Boccaccio, M.D. is Board Certified with the ABMS Board of Surgery. Dr. Boccaccio graduated from Wayne State University and performed

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    John E. Boccaccio, MD
  • Donn Schroder, MD

    Dr. Donn Schroder is board certified in general surgery. He has practiced surgery for over 20 years and is experienced in the latest techniques.

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    Donn Schroder, MD

Biliopancreatic Diversion BPD

Biliopancreatic Diversion BPD

These operations combines removal or exclusion of 2/3rds of the stomach along with a long intestinal bypass which significantly reduces the absorption of fat. The capacity to eat is greater than with the other operations, and the eventual weight loss is the best of all the operations but if fatty foods are overeaten e.g. a hamburger and fries then diarrhoea and foul flatus will result.

Advantages:

  • Greater stomach capacity (200-250 ml) therefore can eat a small main meal instead of n entrée portion

  • Best weight loss of all techniques 70-90% EWL over 2yrs

  • Weight loss is well maintained

  • Adjustable and partially reversible, but only by further surgery

  • A very good option for revision if other techniques have failed

Disadvantages:

  • Open operation (usually), therefore greater operative risks e.g infection, Bowel leak, Clots to legs and lungs wound infection and hernia, chest infection. Risk of Death 1:200

  • Malabsorption to some minerals vitamins and Protein. Patients must commit to taking lifelong supplements of the fat soluble vitamins (ADEK) Calcium and sometimes Iron

  • Risk of deficiency state e.g. Iron deficiency anemia or osteoporosis if supplements not taken

  • Take longer to recover (6-8 weeks off work)

  • Requires removal of Gall bladder because of high incidence of stone formation

  • Increased stool frequency 2-4/day

  • Flatulance if fatty foods eaten

Sometimes it is offered to patients as part of a two stage Bypass operation particularly if they are super obese (BMI>60) because it allows good weight loss until the patient gets down to a safe weight and the more radical bypass can then be offered laparoscopically when they are at a safer weight.

The residual stomach capacity is about 200 ml so a generous entree should be possible.

The weight loss seems to be of the same order as a lap band (50-60% EWL) over two years but it is not adjustable.

It might also be a good option if patients have a problem with their lap band requiring revision, have already lost a lot of weight and don't want a full bypass.