Really need an UNBIASED answer
Your welcome. I see you had a lot of additional replies since I posted. Please research carefully, which sounds like you are. My experience is not the average, but there are a few of out there. You might also want to read and post on the yahoo group which is http://health.groups.yahoo.com/group/duodenalswitch/
I am a member there, but can't keep up with all the boards anymore. I try to pop into them from time to time though, and spend most of my little bit of spare time here.
I am a member there, but can't keep up with all the boards anymore. I try to pop into them from time to time though, and spend most of my little bit of spare time here.
Ginger<><
Revision #2 Dr John Rabkin June 21, 2013; First Revision DS - Dr Maguire 5-18-09; First DS 7-15-2003 Dr Clark Warden = Third time is the charm 
"Now one of the reasons I am going with DS is BECAUSE it has a really low mortality rate" I believe that this is the statement that has many folks up in arms at me? Is it not a true statement that DS has a very low mortality rate (in other words not a whole lot of folks die from DS surgery)?
According to this article:
"Because of their complexity, Dr. Greenbaum said he usually performs duodenal switch procedures with a traditional open incision. He reserves the laparoscopic procedure for those patients who have much less excess weight to lose. The reason: Open duodenal switch procedures have a lower national mortality rate (.76 percent or 7.6 patients per 1000) compared to laparoscopic procedures (12 per 1000)." (http://www.lourdesnet.org/services/duodenal.php) DS surgeries have a LOW mortality (death) rate for this doctor.
Now compare this with a study published on PubMed:
"Of the 1,437 questionnaires sent, 453 (31%) were returned. Sixty-eight of the surgeons did not do any LAGBs, 350 had no operative mortalities, and 35 (9%) reported at least one operative mortality and had a total of 36 operative deaths and 19 late deaths, for a grand total of 55. Five additional deaths occurred after reoperations for LAGB, following removal, revisions, or conversions to another bariatric procedure. Of 62 deaths, the causes were: 20 (33%) cardiac origin, 11 (18%) thromboembolic, ten (16%) GI perforations, three (5%) bleedings, and 18 miscellaneous. Of all deaths, 40% occurred remotely from the band insertion date." (http://www.ncbi.nlm.nih.gov/pubmed/19707838)
yes I understand that we are looking at 1 doctors findings about DS compared to a whole boatload of doctors with LAGB. Kind of like comparing apples and oranges I suppose.
So although I did not quote anyone's findings with my original statement I really wasn't trying to debate the mortality rates of ANY of the surgeries but trying to find out what would be good questions concerning mortality rates of the doctor and/or doctors I would be looking into in my research.
hope this clarifies the intent of my original post.
According to this article:
"Because of their complexity, Dr. Greenbaum said he usually performs duodenal switch procedures with a traditional open incision. He reserves the laparoscopic procedure for those patients who have much less excess weight to lose. The reason: Open duodenal switch procedures have a lower national mortality rate (.76 percent or 7.6 patients per 1000) compared to laparoscopic procedures (12 per 1000)." (http://www.lourdesnet.org/services/duodenal.php) DS surgeries have a LOW mortality (death) rate for this doctor.
Now compare this with a study published on PubMed:
"Of the 1,437 questionnaires sent, 453 (31%) were returned. Sixty-eight of the surgeons did not do any LAGBs, 350 had no operative mortalities, and 35 (9%) reported at least one operative mortality and had a total of 36 operative deaths and 19 late deaths, for a grand total of 55. Five additional deaths occurred after reoperations for LAGB, following removal, revisions, or conversions to another bariatric procedure. Of 62 deaths, the causes were: 20 (33%) cardiac origin, 11 (18%) thromboembolic, ten (16%) GI perforations, three (5%) bleedings, and 18 miscellaneous. Of all deaths, 40% occurred remotely from the band insertion date." (http://www.ncbi.nlm.nih.gov/pubmed/19707838)
yes I understand that we are looking at 1 doctors findings about DS compared to a whole boatload of doctors with LAGB. Kind of like comparing apples and oranges I suppose.
So although I did not quote anyone's findings with my original statement I really wasn't trying to debate the mortality rates of ANY of the surgeries but trying to find out what would be good questions concerning mortality rates of the doctor and/or doctors I would be looking into in my research.
hope this clarifies the intent of my original post.
LapBand has the lowest MORTALITY rate (people dying within 30 days) of the bariatric surgeries.
DS has the highest mortality rate of the bariatric surgeries, BUT you also have to take into account that these statistics include a non-comparable patient population, because of surgeon and insurance company biases - DS patients on average are heavier and sicker than the average band, sleeve or RNY patient. But the rates are in the 0.5 - 1.5% range for all bariatric surgeries.
But it doesn't end there, of course. With a huge percentage of lapband patients having complications that make them miserable (pain, puking, etc.), and something like 60% of patients losing their bands over time, as well as the long term weight loss failure rate, the CUMULATIVE MISERY INDEX (if there isn't one, there should be) tips highly in favor of the DS.
As a comparison, perhaps you should consider the safety (30 day mortality rate) of not having surgery, compared with the long term mortality rate of remaining morbidly obese. In Marceau's 15 year study, after a few years the long term mortality rate for DSers returns to almost the same rate as the rest of the population.
But you REALLY need to get a better grasp of the meaning of these words and concepts - you clearly don't understand some of what you are trying to talk about right now, which makes discussing these things frustrating and confusing to both you and the people on the board trying to help you. Perhaps you would be better served by spending a couple of weeks reading the posts on this board, as well as other boards, before you start asking questions.
DS has the highest mortality rate of the bariatric surgeries, BUT you also have to take into account that these statistics include a non-comparable patient population, because of surgeon and insurance company biases - DS patients on average are heavier and sicker than the average band, sleeve or RNY patient. But the rates are in the 0.5 - 1.5% range for all bariatric surgeries.
But it doesn't end there, of course. With a huge percentage of lapband patients having complications that make them miserable (pain, puking, etc.), and something like 60% of patients losing their bands over time, as well as the long term weight loss failure rate, the CUMULATIVE MISERY INDEX (if there isn't one, there should be) tips highly in favor of the DS.
As a comparison, perhaps you should consider the safety (30 day mortality rate) of not having surgery, compared with the long term mortality rate of remaining morbidly obese. In Marceau's 15 year study, after a few years the long term mortality rate for DSers returns to almost the same rate as the rest of the population.
But you REALLY need to get a better grasp of the meaning of these words and concepts - you clearly don't understand some of what you are trying to talk about right now, which makes discussing these things frustrating and confusing to both you and the people on the board trying to help you. Perhaps you would be better served by spending a couple of weeks reading the posts on this board, as well as other boards, before you start asking questions.
Good grief. That doesn't make even a BIT of sense, and it certainly isn't ANYTHING like what I said, and I can't imagine how you got to that conclusion from what I wrote.
The DS has the highest mortality rate because it is the most difficult procedure to do, and it is done on a population that is on average older, fatter and sicker.
PLEASE PLEASE PLEASE do a whole lot more reading before you post further - you need to understand a lot more about the DS, which information is easily obtainable, before you take people's time with bizarre questions like this.
The DS has the highest mortality rate because it is the most difficult procedure to do, and it is done on a population that is on average older, fatter and sicker.
PLEASE PLEASE PLEASE do a whole lot more reading before you post further - you need to understand a lot more about the DS, which information is easily obtainable, before you take people's time with bizarre questions like this.
Diana said absolutely nothing about numbers of surgeries having a bearing on comparative mortality rates. Not a peep.
I think you might be doing something that my husband does when he tries to communicate. When he doesn't really know what's going on, he sorts through examples of things that he thinks MIGHT match up to what's going on/being said and tells those examples as stories. Then he puts a question mark at the end. I'm supposed to divine from the nature of his example what he's really wanting to ask.
The way I wade through that swamp is to compare what I said with what he said and ask WTF he's talking about. I insist that he clarify and re-clarify. He then tells various versions of his example....well, sometimes he does that. Other times he tells entirely different stories, hoping to find a match. Eventually I notice a theme in his stories and it gives me a clue what he's thinking.
This is excruciatingly frustrating and trust me, I wouldn't go through that torment with ANYONE except him.
So, I am going to suggest this: Stop trying to summarize or restate what people are telling you in this way.
To stick with this most recent example of your communication issue: It is clear that you did not understand precisely WHAT Diana was saying caused those differences in statistics. How did you arrive at the unrelated idea that she was talking about numbers of surgeries performed?
You would have been better served, in this case, to have simply said, "So what are the variables impacting mortality rates, exactly? I'm not getting it."
Or perhaps you don't know how to compare apples to apples in this subject area yet. You have to learn the difference between an apple and an orange in order to make appropriate comparisons. That bit of understanding seems to be missing. And that's not a slam. That's an attempt to point out that you're trying to forge ahead in your learning while missing some important foundation pieces, if you'll pardon my mixing of metaphors.
I think you might be doing something that my husband does when he tries to communicate. When he doesn't really know what's going on, he sorts through examples of things that he thinks MIGHT match up to what's going on/being said and tells those examples as stories. Then he puts a question mark at the end. I'm supposed to divine from the nature of his example what he's really wanting to ask.
The way I wade through that swamp is to compare what I said with what he said and ask WTF he's talking about. I insist that he clarify and re-clarify. He then tells various versions of his example....well, sometimes he does that. Other times he tells entirely different stories, hoping to find a match. Eventually I notice a theme in his stories and it gives me a clue what he's thinking.
This is excruciatingly frustrating and trust me, I wouldn't go through that torment with ANYONE except him.
So, I am going to suggest this: Stop trying to summarize or restate what people are telling you in this way.
To stick with this most recent example of your communication issue: It is clear that you did not understand precisely WHAT Diana was saying caused those differences in statistics. How did you arrive at the unrelated idea that she was talking about numbers of surgeries performed?
You would have been better served, in this case, to have simply said, "So what are the variables impacting mortality rates, exactly? I'm not getting it."
Or perhaps you don't know how to compare apples to apples in this subject area yet. You have to learn the difference between an apple and an orange in order to make appropriate comparisons. That bit of understanding seems to be missing. And that's not a slam. That's an attempt to point out that you're trying to forge ahead in your learning while missing some important foundation pieces, if you'll pardon my mixing of metaphors.
As Diana said, it doesn't sound like you understand quite a bit of what you are reading. You're making comparisons and drawing conclusions that don't make sense. Perhaps it's in how you're wording what you write, but it sounds like you're using terminology without really knowing what it means.
I'm not sure how to help you learn the stuff you need to learn in order to understand this stuff more clearly. I know I could teach you, but I don't have time. Got papers to write, since the semester is almost over :-).
I'm not sure how to help you learn the stuff you need to learn in order to understand this stuff more clearly. I know I could teach you, but I don't have time. Got papers to write, since the semester is almost over :-).
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