Biliopancreatic Diversion

Biliopancreatic diversion (BPD) is a weight-loss surgery that changes the path food takes through your digestive system, reducing how many calories and nutrients your body absorbs. It is one of the most effective bariatric procedures for severe obesity but requires lifelong nutritional monitoring and supplementation due to reduced absorption of vitamins and minerals.

Biliopancreatic diversion (BPD) is a malabsorptive bariatric procedure involving a distal gastrectomy (leaving a 200–500 mL gastric pouch) and division of the small intestine into two limbs: a short alimentary limb and a longer biliopancreatic limb that join in a common channel of 50–100 cm. This anatomical rearrangement severely limits fat and protein absorption, producing 70–80% excess weight loss. The BPD with duodenal switch (BPD-DS) variant preserves the pylorus and creates a sleeve gastrectomy rather than a pouch.

BPD achieves the greatest and most durable weight loss of all bariatric procedures, particularly for patients with BMI above 50. However, the higher risk of nutritional deficiencies and complications means it is reserved for carefully selected patients after thorough evaluation at a specialised centre.