What is Pancreaticobiliary bypass Procedure?
This operation involves a sleeve gastrectomy and bypass of most of the small bowel. Whilst the sleeve gastrectomy acts to restrict the amount of food eaten
, much of the effect of this procedure comes from malabsorption produced by bypassing most of the small bowel. Unlike the gastric bypass operation where the small bowel is divided 80 cm from its upper end the small bowel is divided 300 cm from where it joins the large bowel (close to its far end). Once divided the far piece of small bowel is called the intestinal limb and the near end of the small bowel the pancreatico-biliary limb. The bowel is divided again at the point where the stomach becomes the duodenum (the duodenum is the very first part of the small bowel). The far end of the small bowel (intestinal limb) is then brought up and joined to the duodenum. Food will now pass through the refashioned stomach and straight into the very last part of the small bowel. It is then necessary to join the near end of the small bowel (pancreaticobiliary limb) to the intestinal limb 100cm from the point where it joins the large bowel. This ensures that all the digestive juices that come from the gallbladder, pancreas and small bowel are mixed in with the food and digest it.
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