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Fig. 5. Biliopancreatic diversion (Scopinaro [40]). A distal gastrectomy is performed. Small bowel is divided 250 cm proximal to ileocecal valve, and is anastomosed to the stomach remnant. The biliopancreatic limb (BPL) is anastomosed to the side of the distal limb 50 cm proximal to the ileocecal valve, to form a 200-cm alimentary limb (AL) and a 50-cm common limb (CL) where the major digestion occurs. The proximal gastric pouch initially restricts intake, which is maintained by the reduced absorptive area. Cholecystectomy is done to prevent gallstones from bile stasis and rapid weight loss.
