Recent Study comparing DS to GB
FYI. I came across this summary of the study and noted the editorial comment about the DS. I was not able to get the editorial but the abstract looked favorable or at least neutral to the DS so I was surprised by the editorial comment.
Duodenal Switch Surgery Riskier Than Gastric Bypass
The first randomized comparison of gastric bypass and duodenal switch surgery, published in the Annals of Internal Medicine, shows greater weight loss and improvements in cardiovascular risk factors with duodenal switch, but at the expense of more adverse events.
Two years after gastric bypass or duodenal switch was performed on some 60 patients with superobesity (BMI, 50 to 60), most cardiovascular risk factors improved in both groups. Duodenal switch patients had greater weight loss than bypass patients (mean loss, 74 vs. 51 kg), as well as greater reductions in total and LDL cholesterol. However, they also had more adverse events (62% vs. 32%); in particular, malnutrition-related events such as night blindness, severe iron deficiency, and protein calorie deficiency occurred only after duodenal switch.
An editorialist notes that few patients had adverse cardiovascular profiles to begin with and concludes: "We should seriously question whether there is any role for the duodenal switch operation ... its complications are very real and very severe."
Annals of Internal Medicine article (Free abstract)
Annals of Internal Medicine editorial (Subscription required)
-Band to DS revision on 06/21/2011!
Highest known Wt/ Lowest Wt (Banded)/ Regain-Starting Wt/ Current Wt/ Goal Wt
379.6/ 272/ 342/ 169/ South of 200
With the inadequate and even dangerous diet advice post-op DSers get, like a chewable multivitamin is good enough, it doesn't suprise me that there are negative outcomes.
BUT - these deficiencies are normally preventable with correct supplementation. I'm not sure you can blame it on the surgery itself rather than the crappy surgical aftercare and ignorance about what DS patients need to stay healthy.
I bet if they compared post-op patients that were correctly advised of their new nutritional needs, the DS would come out as clearly superior to the GB result wise.
I feel so sorry for those DS patients who don't know about this website or have access to the proper info.
I just wish we had better educated medical professionals out there to help us out a bit more.
Sher-
All participants were prescribed daily supplements of
multivitamins, 100 mg of iron sulfate, 1000 mg of calcium
carbonate, and 20 mcg of vitamin D3. In addition, participants
in the gastric bypass group received a vitamin B12
substitute. Ursodeoxycholic acid was prescribed for 6
months, except in participants who had had cholecystectomy.
Participants were seen by a dietitian and surgeon at
inclusion and at 6 weeks, 6 months, 1 year, and 2 years
after surgery. The dietitian visits included a dietary recall
and evaluation of nutritional status and adherence to vitamin
supplementation. Participants received top-up supplementation
according to predefined cutoff levels of vitamin
concentrations (23).
That seems really low, expecially the Vitamin D3. That's only 800 IU. I take 15,000 a day now and I'm pre-op.
I'd be interested to hear what some of the vets think of this study.
Click! > DS Documents ~ VitaLady.com ~ DSFacts.com ~ OH DS FB
I am not a vet but as a health care professional I call big piles of BS on this one and would not let it sway me in my decision. My surgeon requires appointments (and labs) at 4 weeks, 3 months, 6 months, 9 months, 12 months, 18 months, 24 months, then yearly thereafter. Further, elevated LFTs is a result of weight loss and will likely resolve on its on. Vitamin deficiencies are treatable as well.
Do you know who authored the editorial? I didn't recognize the name of the any of the authors for the study. My guess is some of the well known DS surgeons will provide a rebuttal. But that won't likely get any press.
-Band to DS revision on 06/21/2011!
Highest known Wt/ Lowest Wt (Banded)/ Regain-Starting Wt/ Current Wt/ Goal Wt
379.6/ 272/ 342/ 169/ South of 200
1.editorials really do not carry that much importance - they add to an author's resume of published material but are not cited as research articles.
2.the original article is pretty "thin" in content value because of the statistically insignificant number of patients studied - very low number actually,
the relatively reduced number of parameters observed,
the extremely short time of observation;
as well as the low number of resources cited in support of their observations (medication especially is very hard to quantify in outpatient cir****tances and rely on the patients' own words.)