Diagram of stomach before and after Duodenal switch procedure

Duodenal switch bariatric surgery (DS) is a procedure that results in the greatest overall weight loss. In addition, it offers the best control of metabolic conditions, like diabetes. This particular bariatric procedure is less common because it is more complex; patients must commit to life-long vitamin supplementation and a diet of protein-dense foods. Physicians and the bariatric teams must carefully monitor patients and provide education to reduce the incidence of nutritional side effects.

At United Bariatric Center of Kansas City, we are local leaders in duodenal switch surgery, offering expertise and experience for patients seeking maximum weight loss in the Blue Springs, Lee’s Summit, and surrounding Kansas City areas.

RELATED: Consider the Orbera Stomach Balloon Procedure

What’s The Duodenal Switch Bariatric Surgery Procedure Like?

protein and fat

The duodenum, or the first portion of the small intestine, is divided just past the outlet of the stomach. A segment of the distal (last portion) small intestine is then brought up and connected to the outlet of the newly created stomach so that when the patient eats, the food goes through a newly created tubular stomach pouch and empties directly into the last segment of the small intestine. Roughly three-fourths of the small intestine is bypassed by the food stream.

The bypassed small intestine, which carries the bile and pancreatic enzymes that are necessary for the breakdown and absorption of protein and fat, is reconnected to the last portion of the small intestine so that they can eventually mix with the food stream. Similar to the other surgeries described above, the BPD/DS initially helps to reduce the amount of food that is consumed; however, over time this effect lessens and patients are able to eventually consume near “normal” amounts of food. Unlike the other procedures, there is a significant amount of small bowel that is bypassed by the food stream.

Additionally, the food does not mix with the bile and pancreatic enzymes until very far down the small intestine. This results in a significant decrease in the absorption of calories and nutrients (particularly protein and fat) as well as nutrients and vitamins dependent on fat for absorption (fat-soluble vitamins and nutrients). Lastly, the BPD/DS, similar to the gastric bypass and sleeve gastrectomy, affects guts hormones in a manner that impacts hunger and satiety as well as blood sugar control. The BPD/DS is considered to be the most effective surgery for the treatment of diabetes among those that are described here.


  1. Results in greater weight loss than RYGB, LSG, or AGB, i.e. 60 – 70% percent excess weight loss or greater, at 5 years follow up
  2. Allows patients to eventually eat near “normal” meals
  3. Reduces the absorption of fat by 70 percent or more
  4. Causes favorable changes in gut hormones to reduce appetite and improve satiety
  5. Is the most effective against diabetes compared to RYGB, LSG, and AGB


  1. Has higher complication rates and risk for mortality than the AGB, LSG, and RYGB
  2. Requires a longer hospital stay than the AGB or LSG
  3. Has a greater potential to cause protein deficiencies and long-term deficiencies in a number of vitamins and minerals, i.e. iron, calcium, zinc, fat-soluble vitamins such as vitamin D
  4. Compliance with follow-up visits and care and strict adherence to dietary and vitamin supplementation guidelines are critical to avoiding serious complications from protein and certain vitamin deficiencies

In conclusion, duodenal switch bariatric surgery is the most effective procedure for those seeking the greatest overall weight loss and control of metabolic conditions like diabetes.

Though the procedure carries a higher risk of complications and requires lifelong vitamin supplementation and a protein-dense diet, the potential benefits of this procedure should be weighed against the potential risks when considering bariatric surgery.

If you have been considering duodenal switch surgery, the United Bariatrics Center of Kansas City can help you make the right decision for you. Attend one of our Seminars or give us a call at (816) 254-9292 to learn more!

*Results may vary

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We have 3 locations in the Kansas City area:

➡ Independence – Near Centerpoint Hospital: 19101 B Valley View Parkway, Independence, MO 64055 – Directly across the street from Costco
➡ Lee’s Summit – Lee’s Summit Medical Center: 2100 SE Blue Pkwy, Suite 120, Lee’s Summit, MO 64063
➡ Kansas City – St. Joseph Medical Center: 1000 Carondelet Drive, Suite 203B, Kansas City, MO 64114

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What are the benefits of duodenal switch bariatric surgery?

The benefits of duodenal switch bariatric surgery include the greatest overall weight loss and the best control of metabolic conditions like diabetes.

What are the risks of duodenal switch bariatric surgery?

The risks of duodenal switch bariatric surgery include higher complication rates and risk for mortality, a longer hospital stay, and potential for protein deficiencies and long-term deficiencies in a number of vitamins and minerals.