Common channel length

Hello all,

I have a question... I am wondering what your thoughts/experiences with common channel length have been?

I am hoping to get surgery with Dr Gagner in a few weeks. My husband and I met with him recently and he informed me that he does 100 as a standard for the common channeland 150 for the alimentary limb.

He also does not remove the gall baldder or appendix. (He gave a very good medical reason for this which I have written down somewhere but cannot locate presently).

 I would like to hear from those of you who have similar  CC and AL lengths and did not have the GB and Appendix removed.

What has your weight loss been like?

Any issues with gall stones later?

Thanks in advance



Sara

Gagner did my DS in 2000.  My common channel is 75cm and he removed my gallbladder.

Hi Sara

I had that exact surgery with Dr Gagner on 6/8/11; 100 cm common channel and 150 cm alimentary limb. I have lost over 70 pounds so far, which I think is pretty respectable. My starting BMI was 40-ish.

I still have my gallbladder and appendix. I wanted to have at least the gallbladder out, but he won't take it out unless it is diseased-looking. He and I did not agree on this 100%, but obviously he won out, because I still have mine!

He will give you Actigall, a medication to help prevent gallstones. It did not agree with me and I am not taking it anymore. I fully expect to have my gallbladder out within a year or so, because statistically speaking, stones will develop. I have not had symptoms or problems with it so far, however.

My surgery experience was excellent and my recovery was easy. I hope you have the same experience. Good luck!

Karen

Uggg, I was on Actigal for six months and hated every single day of it. I begged the doctor to take me off it, but he said no. I didn't end up with gallbladder disease so I guess it worked, but I still hated it.

CC is 200 ..... Gall bladder and appendix gone........ 138 lb weight loss ....  Slim Stevie

 That's a pretty standard configuration.  Some surgeons use what's referred to as the "Hess" method, developed by Dr Hess, the pioneer of the DS.  The Hess method uses your overall small bowel length to figure out proportions for the alimentary limb and common channel.  Others use standard measurements.  What Dr Gagner is suggesting is a pretty standard DS (and that's a good thing).  

He's got an excellent reputation so I wouldnt have any worries trusting his judgement on that.

FWIW, my alimentary limb is the same (150cm), and my common channel is slightly longer (125cm).  I'm about 10 pounds under my goal of a normal BMI.

Refusal to remove gallbladder and appendix would be a deal breaker for me.

I have a Hess style configuration, where the biliopancreatic limb is 60% of total small bowel length and the alimentary limb 40%, with a common channel close to 10% (and included in the alimentary limb measurement) of 75 cm.

Excellent weight loss, excellent maintenance, and so far only minimal and "normal" malabsorption issues with D, A and calcium. All well treated and maintained with aggressive supplementation and regular labs to keep track of values.

Me too!!  And that's why I like the Hess method, what I have observed is that those are the results with 'most' Hess method patients.  Of course, that's a casual observation, totally non-scientific.

I was pretty happy that I did not have to talk Dr. M. into it as he was already using the Hess method.

Thanks to everyone that has responded.

I was suprised to learn that he did not remove the gall bladder and appendix. For anyone that is interested I did locate my notes and he said that removal of the gb increases the risk of injury to the bile duct, apprarantly he has published on this. He also stated that the risk of issues with the appendix reduces with age and removal is not justified due to the possible increase in infection risk. He also said that with this type of surgery there is a later increased risk of kidney stones.

All in all I do trust his judgment and feel he is a good surgeon with a good reputation. It is good to be informed so you can make the right choice for yourself. I found the surgeon sample question list on dsfacts to be invaluable when preparing to meet with him and advise any new people to check it out.

I have a 100 cc and 150 ac. My surgeon not only left my gallbladder and appendix but he did not prescribe Actigall or equivalent. I'm almost 11 months out and so far (knock hard on wood) neither have caused me problems. I do wish he had taken them out just to head off problems later one, but it wasn't a deal breaker for me.