A biliopancreatic diversion changes the normal process of digestion by making the stomach smaller and letting food bypass part of the small intestine so that fewer calories are absorbed. This is quite a major operation requiring three to five days stay in the hospital and rest for at least three to five weeks more before normal work can be resumed. The operation can also be done through laprascopy where only a small incision is made and the operation carried out using a camera.
Laproscopic operation requires smaller incision and the post operative recovery is faster. The open surgery is quite a big one with the incision of the stomach being quite large. It needs a well qualified and highly experienced doctor to make it successful. In lesser hands anything can go wrong. The stomach is cut and a bypass done which connects the smaller stomach to the lower part of the small intestine thus bypassing the duodenum and other organs of the abdomen. This procedure requires great skill.
The procedure may take at least four to five hours under complete sedation and requires hospitalization for a few days. The patient has to take complete bed rest. If he gets up, his stomach may hurt. He has to have a strictly liquid diet for complete recovery. If the food he takes is not ingested properly, it may result in indigestion, diarrhea, foul smelling stools and the like. After a few days he can have semi solid food. He can walk about if he has no pain but he should not strain himself nor overdo anything. He should not lift heavy things, he should not bend and he should take things easy.
Once he goes home he should keep a strict check on his temperature. Fever may be a precursor of some infection of the wound. He should inform the doctor if there is anything unusual, if he has sudden pain or swelling or excessive vomiting. The stomach being smaller, it has to get used to the new quantity of food the patient eats. Once this is settled, the patient should still rest for three to five weeks till the entire wound, internally and externally is healed. He should be in touch with his doctors and obediently take the medicines prescribed.
If some of the stomach acids leak into the intestines, there may be perforations of the intestinal walls, which may cause pain and fever. He should contact the doctor. As most of the food does not pass through that part of the intestine which is responsible for the absorption of essential vitamins and calcium, the patient may develop vitamin and calcium deficiency resulting in many problems. In fact thirty percent of patients of biliopancreatic diversion develop vitamin deficiency within a year. He should take vitamin supplements regularly. The main post operative job is to have regular check ups and see that everything is okay.
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