BPD: Biliopancreatic diversion. A 400 mL gastric pouch is formed from the stomach. The small bowel is divided 250 cm proximal to the ileocecal valve and is connected to the gastric pouch to create a Roux-en-Y gastroenterostomy. An anastomosis is performed between the excluded biliopancreatic limb and the alimentary limb 50 cm proximal to the ileocecal valve. In BPD-DS, a vertical sleeve gastrectomy is constructed and the division of the duodenum is performed immediately beyond the pylorus. The alimentary limb is connected to the duodenum, whereas the iliopancreatic limb is anastomosed to the ileum 75 cm proximal to the ileocecal valve. The included figures are the property of Johnson and Johnson and Ethicon Endo-Surgery (Europe). They are reproduced here with their kind permission.