The resolution rate for diabetes and overall weight loss has often been best achieved with a duodenal switch. Presently, there are no surgical programs in San Antonio, Corpus Christi, Austin, or Laredo that offer the duodenal switch at their Practice on a routine basis. Like any other surgical procedure, it is important to weigh the pros and cons of each procedure and to apply these benefits and risks to one’s own personal situation.
The duodenal switch may be the optimal procedure in patients who are super-obese such that their Body Mass Index is over 60kg/m2. However, in order for a surgeon to perform a duodenal switch, they need to have an extra degree along with years of surgical expertise, but it is Texas Bariatric Specialists’ opinion that this procedure be performed only for patients with a BMI exceeding 60kg/m2. Even with a surgeon specializing in this procedure, important considerations need to be addressed regarding the risks involved after surgery including, but not limited to, death and nutritional complications. These risks should be discussed extensively with the surgeon prior to surgery. Unfortunately, it is the overwhelming opinion of most bariatric surgeons that the duodenal switch has a high risk profile which exceeds its benefits. The percentage of major morbidity and death after the duodenal switch is significantly higher than the laparoscopic gastric bypass. In addition, long-term nutritional complications such as chronic renal stones and vitamin A deficiencies could lead to long-term medical problems such as night blindness, other fat-soluble vitamin deficiencies, and malnutrition.
At Texas Bariatric Specialists (TBS), Dr. Patel would consider a duodenal switch only in patients with a BMI of 60 or greater. There is still controversy in regards to this procedure still and whether it may be the optimal therapy for patients with such a high body mass index. Most surgeons believe the laparoscopic gastric bypass is the best procedure for patients with a higher BMI.
For more information and to find a surgeon specializing in the duodenal switch, please refer to the American Society of Metabolic and Bariatric Surgery.