Abstract
Biliopancreatic diversion (also known as duodenal switch) is a complex bariatric surgery that includes a sleeve gastrectomy and long Roux-en-Y intestinal bypass. The jejunojejunal anastomosis is very distal resulting in the bypass of two-thirds or more of the intestine. Patients lose weight not only because nutrients bypass most of the intestine, thereby reducing the absorption area, but also because nutrients join the biliopancreatic secretions and enzymes only distally leading therefore to their reduced digestion and absorption. This is a very effective surgery for weight loss, but can be complicated by severe malnutrition. In such cases, surgical reversal of the duodenal switch is done by creating a proximal anastomosis between the alimentary and biliopancreatic limbs. To our knowledge, endoscopic reversal of the duodenal switch has not been reported previously.
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