Table 1.
Stomach | Duodenum | Proximal intestine | Distal intestinal | |
RYGB | Decreased capacity to 15-30 mLChyme bypasses 90% of stomachDecreased gastric transit time | Bypassed by chyme | Proximal jejunum bypassed by chymeRapid exposure of distal jejunum to chymeBile mixes with chyme in proximal ileum | Earlier exposure to chyme |
AGB | Restrictive band around gastric cardiaDirect pressure on vagus nerves | No alterations | No alterations | No alterations |
BPD/DS | Decreased capacity to 60-150 mL85%-90% of stomach removedAccelerated gastric emptying by 2-fold to 3-fold | Bypassed by chyme | Chyme bypasses jejunum Rapid exposure of ileum to chymeBile mixes with chyme in distal ileum | Rapid exposure to chime |
SG | Decreased capacity to 60-150 mL85%-90% of stomach removedAccelerated gastric emptying by 2-fold to 3-fold | More rapid exposure to chyme | Possibly earlier exposure to chyme | Possibly earlier exposure to chyme |
AGB: Adjustable gastric band; BPD/DS: Biliopancreatic diversion with or without duodenal switch; RYGB: Roux-en-Y gastric bypass; SG: Sleeve gastrectomy.