The Three Major Bariatric Procedures
In bariatric surgery we have three major groups of the procedures. They are restrictive procedures, like adjustable gastric bands. There are procedures which are more malabsorptive like biliopancreatic diversion, and procedure which are mixed, restrictive and malabsorptive like gastric bypass.
Biliopancreatic diversion is a procedure, which is more adequate for severely malignant obese patient, and that procedure gives more malabsorption. The absorption of the nutrients is less than we have with a gastric bypass. That causes, unfortunately, more symptoms of protein malnutrition and calcium malnutrition and unfortunately more diarrhea than gastric bypass.
Gastric bypass is a sort of like middle, in between the restrictive procedure and malabsorptive procedures, causing some malabsorption and some restriction. By creating a small pouch, about 15-20 cc in volume and connecting this pouch to the small bowel, we bypass very short segment of the small bowel and the stomach. That causes less malabsorption, more absorption of the good nutrient and less complication like protein malnutrition or diarrhea.
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