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The duodenal switch (DS) procedure, also known as a gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. The restrictive portion of the surgery involves removing approximately 70% of the stomach (along the greater curvature) and most of the duodenum .
For severe duodenal ulcers, it may be necessary to remove the lower portion of the stomach and the upper portion of the small intestine. If there is a sufficient portion of the upper duodenum remaining, a Billroth I procedure is performed, where the remaining portion of the stomach is reattached to the duodenum before the common bile duct.
[35] [64] People in recovery are encouraged to compose their diet mainly of plant-based foods and soft proteins (1.0–1.5g/kg/day). [35] [64] During recovery, people must adapt to eating more slowly and avoid eating past fullness; overeating may lead to nausea and vomiting.
In 1810, his student Daniel Merrem successfully performed the resection of the distal stomach and reconnected the duodenum to the stomach in animal experiments. [12] The first clinical attempt of a gastric resection occurred in 1879 by French surgeon Jules-Émile Péan, who unsuccessfully carried out a pylo-rectomy for a cancer patient. [12]
What does change, over time, is the size of the connection between the stomach and intestine and the ability of the small intestine to hold a greater volume of food. Over time, the functional capacity of the pouch increases; by that time, weight loss has occurred, and the increased capacity should serve to allow maintenance of a lower body weight.
The shared blood supply of the pancreas, duodenum and common bile duct necessitates en bloc resection of these multiple structures. Other indications for pancreaticoduodenectomy include chronic pancreatitis , benign tumors of the pancreas , cancer metastatic to the pancreas, multiple endocrine neoplasia type 1 [ 5 ] and gastrointestinal stromal ...
Resection is sometimes a part of a treatment plan, [2] but duodenal cancer is difficult to remove surgically because of the area that it resides in—there are many blood vessels supplying the lower body. Chemotherapy is sometimes used to try to shrink the cancerous mass. Other times intestinal bypass surgery is tried to reroute the stomach to ...
Billroth I, more formally Billroth's operation I, is an operation in which the pylorus is removed and the distal stomach is anastomosed directly to the duodenum. [1] [2] The operation is most closely associated with Theodor Billroth, but was first described by Polish surgeon Ludwik Rydygier. [2] The surgical procedure is called a ...