BPD can be performed satisfactorily by laparoscopy. Avoiding the gastrectomy is an interesting option to reduce technical difficulties, the surgeon's stress, duration of the operation, the patient's stress, and, probably, postoperative morbidity and mortality. We consider an upper digestive endoscopy to be mandatory to determine, before operating, if the patient will need a gastrectomy, depending on its results.

It has been proven that BPD can be performed satisfactorily using laparoscopy, but this technique requires a very skilled and experienced laparoscopic surgeon. Avoiding gastrectomy is a very interesting option in order to reduce technical difficulties, surgeon stress, duration of the operation, patient stress, and, probably, postoperative morbidity and mortality. Laparoscopic BPD with distal gastric preservation is a very promising bariatric procedure with potential advantages over laparoscopic BPD with gastrectomy or open BPD.

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