Another copy and paste for main board!!!

Excess Weight Loss:               Mean Change

Band                                                         47%*

RNY Gastric Bypass (includes long-limb)   62%*

Duodenal Switch                                      70% *

 

Diabetes - resolved

Band                             47.9%

Gastric Bypass               83.8%

Duodenal Switch            97.9%

 

Hyperlipidemia

Band                           58.9%

Gastric Bypass             93.6%

Duodenal Switch         99.5%

 

Hypertension

Band                           43.2%

Gastric Bypass             75.4%

Duodenal Switcch        81.3%

 

Sleep Apnea

Band                            95%

Gastric bypass             80%

Duodenal Switch         92%

 

Operative Mortality Rate:

Band                            0.1%

Gastric Bypass             0.5%

Duodenal Switch         1.1%

 

 

Reservations on Duodenal Switch (DS) has been largely based on concerns of the long-term effect on malnutrition, as well as diarrhea, and is also likely influenced by the serious long-term consequences seen with the original malabsorptive procedure, the jujunoileal bypass.  The SAGES Manual:  A Practical Guide to Bariatric Surgery (2008) states that metabolic disturbances and the number of surgical revisions for malnutrition or diarrhea are considerably less using 100cm as the common channel length.  The manual also states that the DS short-and long-term weight loss exceed that of any other bariatric operation.  It does NOT state that DS should be reserved for super or super-super obese individuals, apparently due to the lack of evidence of high risk in malnutrition and diarrhea with the 100cm common channel, especially among those who adhere to physician advice for nutrition, vitamin supplementation, and regular lab work.  It specifies that the BMI guidelines are the same for all types of bariatric surgeries, including the DS.

 

*Note that the study by Buchwald, et al. (2004) looked at averages across many studies where the patients were measured at different time lengths from their surgery (eg, one year, two years, or 5 years post-op).  Other research that is 10 years post-op (lap-band not available in US patients for last 10 years, only last 7 years), shows that 20% of those with an RNY bypass regain more than 50% of their excess weight loss with comorbidities often coming back.  Less than 5% of those with duodenal switch regain more than 50% of their excess weight.  Fact.  Know your choices & then decide what’s best for you.  Happy Holidays to all those I just may have helped!!!!!!!!!!!!!!!!!!!!!

Interesting information Izzy.  Thanks for posting that.

As I have stated before, I have not researched the DS, I can't have it...so why even look into it.  Heck, I had to twist my nephrologist's arm to agree to the RNY.  The problem I know with the DS is that there is a higher risk of chronic diahhrea and higher risk of kidney stones.  This is why I can't have it.  I'm already at high risk for chronic kidney issues.

Anyway, when people post about the DS, I don't often see posts about the downside of it.  Thought I would add my $.02 for the day.

-Elli

 Cronic diahhrea?  I have (and know of some others) with loose stools but I never knew this was a possible side effect.  I'd also heard about gall stones being a possible side effect but not kidney stones.  That's why most times the gall bladder is removed.

There are definately downsides to the DS, just like there are downsides to all WLS.  Maybe I'm still in the pie-in-the-sky, dreamy phase of life after WLS, but I didn't have any complications with my surgery or afterwards so things have been pretty good for me.  Like everything else, your mileage may vary ...

Yes, chronic diahrea/kidney stones is also a concern with RNY but not as much of a concern.  It has to do with the amount of intestine removed.  I was originally going to have the VSG (when I was going to self pay) and my nephrologist was all for a completely stomach surgery.  When I discovered my insurance would pay in the new year, but for RNY not VSG, we had a talk.  He agreed to the RNY but there are some things he will keep a closer eye on.  One thing was oxylate which has to do with kidney stones.

I'm glad it's working for you though.
-Elli

Very interesting. Makes me lean more towards RNY for resolving diabetes and hypertension. I wonder why sleep apnea is less resolved with RNY than the band. I have that too, and look forward to getting rid of my mask!