Question:
BPD that is not a DS? Whats that?
— [Anonymous] (posted on January 15, 2002)
January 15, 2002
He does the biliopancreatic diversion, but nothing to the stomach? Sounds
like the old type bypass surgery they did in the 70's. They stopped doing
that type of surgery due to nutritional problems (Even though I know
several people who had it and had no problems) Did he give you any type of
diagrams? I always do better when I can see it drawn out. Wonder what
kind of problems the duodenal switch gave him? Sorry asked more questions
than I anwsered.
— m S.
January 15, 2002
BPD. Huge pouch, radically short common channel? Long termers (12-15 yrs)
I have met are still morbidly obese, but have all the same nutritional
problems as someone who is distal RNY, but normal wt. The theory with BPD
is that since a person can eat more food (stomach ends up almost full size
after time), that they can absorb more nutrition. Which is not valid, in
real life. The absence of lower stomach & parts mean the ability to
digest is gone forever, so the calories get on board, but the nutrition
doesn't. I'm not a big fan of it, actually. Since you are self-pay, you
might want to consider shopping further from home. I'm sure you'll be
welcome at the support group, and perhaps he can do yoru follow-up.
— vitalady
January 15, 2002
I would get more information. Have you check out the duodenal switch web
site. there is quite a bit of information there regarding surgery types.
since bpd stands for biliopancreatic diversion, I am wondering how that it
determined to be effective. It the standard DS a partial gastrectomy is
perfomed leaving the stomach about the size of 4 ounces. the duodenum
remains intact and your stomach retains its function as a food grinder.
The intestinal rearrangement is similar to the rny but tends to be distal
with a common channel of 100cms. Both the rny and ds have good statistical
support as to their efficacy. If I were you I would want to know all the
advantages to the BPD and what is realistic for you to expect short and
long term. No one wants to have a revision or a repeat surgery. Do more
research and don't let his personality alone sway you into compromising
your needs. Good luck.
— [Anonymous]
January 15, 2002
I have to put my two cents in and say....RUN..don't walk...RUN. Now, this
is "only" my opinion but, there IS a reason that doctor's don't
do this surgery anymore. Is he honestly telling you that there is no
problems with eating fats??? I have the BPD/DS and if I eat too many fats
I have "severe" diahrea. Okay so no dumping but is diahrea any
better? He "requires" you to take prescription vitamins? Geez,
they are not even enough for me! I am not typical from what i hear from
people but, I can tell you that I have severe deficiencies of iron, calcium
and potassium. And I had the new BPD/DS. I would never ever have the old
surgery of just the BPD. Of course, I wouldn't have the BPD/DS again
either but, that's just me. Many people are very happy with it. I can
honestly tell you that I would opt for the RNY if given the choice again.
True I can most likely eat more and more diversified things than the RNY's
but..I also have many more problems. I know that BPD/DSers don't like it
when I say these things but, at least you get the other side of the story.
It is not "always" a storybook ending. Please research well
before agreeing to this old surgery. Good luck to you. This doctor sounds
alot like one I know. I wish I knew where you lived.
— Barbara H.
January 15, 2002
Just a comment on the last poster.... you can get a revision to a longer
common channel w/ DS.... you can even get put back the way you used to be
since they don't remove anything but a portion of the stomach (unlike the
RNY). I've heard that statistics are that around 4% of DS patients suffer
from malnutrition and need a revision to lengthen the common channel, but
that varies quite a bit from surgeon to surgeon. Do your homework. I
agree that this doc sounds weird to the point I would not feel comfortable
having him as a surgeon.
— [Anonymous]
January 15, 2002
Dear Anonymous, thank you for your input and suggestion about a revision
but, if you can take a minute and look at my profile on here, you will see
that I can't qualify for ANY surgery at this point. My BP and iron levels
are so dangerously low that they refuse to do ANY "elective"
surgeries for fear of stroke. Yes, I have been trying to raise the iron
with injections etc but it just doesn't ever come up to decent levels. I
have also had transfusions. Just wanted to make it clear that I honestly
have researched but as of right now, I am in a catch 22.
— Barbara H.
January 15, 2002
Hi Barbara, I hope I didn't come off as rude in my post. I'm very sorry
for your problems. I guess because I am pre-op I am very uncomfortable
hearing something so drastically negative without trying to offer a
solution to myself. Good luck!
— [Anonymous]
January 15, 2002
You may want to contact a woman named Sharon. She is an 11-year post-op
with the BPD-only. There are reasons why this surgery is not done any
longer and was modified into the current BPD/DS surgery, but if you want
more information about the BPD-only, contact Sharon. Her webpage is at:
http://www.duodenalswitch.com/Patients/Sharon/sharon.html
— [Anonymous]
January 15, 2002
Many thanks from my friend for the answers - as for fats, she said people
in her support group boast of making sugar free pudding with half and half,
they eat fats like crazy! I have no idea if that makes them sick, but they
stay away from carbs like no others, like less than 10 grams per day, of
good AND bad carbs. I think she is still confused, but more informed,
thanks to you. SHe made an appointment with a doc downtown...
— [Anonymous]
January 15, 2002
Hi, everyone. The BPD *is* still performed but the preferred surgery (in
most cases) is the BPD/DS. Why? The partial gastrectomy (it's a sleeve -
only the fundus or storage area is removed) leaves the pyloric valve and a
portion of the duodenum intact (the duodenum is the area where
site-specific nutrients such as iron, calcium and B-12 are absorbed). The
retention of the pylorus and part of the duodenum mean that people can feel
'saiety' and fullness (studies have been shown that chemical processes in
the brain are triggered when food enters the duodenum). Also, the stomach
is able to process the food as pre-op but with less room. Other side
effects of the earlier BPD that the Ds is meant to lessen or eliminate:
Halitosis (bad breath) and dumping syndrome (some people DON'T want it
LOL). The intestinal arrangement of the DS is similar to the BPD but there
is almost always a longer common channel (once again, to maximize
absorption) and a portion of the duodenum is left intact for absorption
(the 'duodenal switch'). The earlier BPD had a common channel of 50 cm and
people showed more nutritional deficiencies with this than a 100 cm common
channel (of course, post=ops must comply with supplement regime and get
proper, regular aftercare and labwork - it isn't just the 100 cm common
channel that prevents nutritional deficiencies). Now, there does appear
to be a trend among *some* surgeons to prefer the BPD over the DS. Why?
BEcause the DS is an extremely difficult surgery. Operating near the
duodenum takes tremendous skill and some surgeons have encountered lack of
blood flow to this area (I've heard of at least two BPD/DS operations being
converted to the earlier BPD because of this lack of blood flow). I'm glad
that this surgeon is upfront about his preferences... However, I would
investigate the DS further and wouldn't settle for anything else IF that is
what you decide you want. There are larger nutritional deficiencies
inherent in the BPD shorter common channel and it really isn't feasable to
make it longer -- this would defeat the malapsorption because of the larger
stomach (the lower antreum is removed in the BPD and this leaves a larger
stomach than the post-op DS sleeve gastrectomy or even the more severe RNy
pouch). So, choose wisely! Sharon is a long term, healthy post-op and
there are others who lead normal, healthy lives after the BPD surgery.
However, I would investigate the DS and the differences between the two
before making any serious final decision. :) The DS website mentioned
(www.duodenalswitch.com) is an excellent one and has DS studies, info as
well as a study comparing the BPD to the DS. There is also a group on
yahoo ([email protected]). There are plenty of post-ops and
pre-ops there discussing all kinds of issues. The trend of some surgeons
to favor the BPD in recent months has been discussed there (check the
archives). Hope this information helps. Please feel free to e-mail me
should you have any questions or concerns! :) All the best, (laparoscopic
BPD/DS with gallbladder removal, January 25, 2001, preop: 307 lbs/bmi 45;
now: 191 lbs/bmi 28)
— Teresa N.
January 16, 2002
"My first instinct is to RUN" I agree with that assessment..
Trust your instincts on this one.. I'm like Barbara H. Research this
decision a little more
— Victoria B.
Click Here to Return