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In a message dated 5/14/01 11:31:59 AM, duodenalswitch writes:

<< Dr. told me she wants to get " in and out " of surgery ASAP

and does not remove the gallbladder or appendix.

>>

Actually Dr. Gagner mentioned that taking out the gallbladder during DS/WLS

is NOt the same as a gallbladder removal procedure and is much more

complicated. He prefers to not remove the gallbladder if it isn't diseased

and put the patient on Actigall to prevent stones. Studies have shown that a

certain percentage of patients will still need the gallbladder removed

sometime in the future.

Presence of stones does not necessarily necessitate gallbladder removal.

People can be totally asymptomatic and not even realize they have stones.

If, however, they have been the cause of pain, etc. then I think there is a

medical reason to indicate removal.

I had large stones (one was 1 cm!) and I pleaded and insisted that the

gallbladder be removed during my laparoscopic BPD/DS surgery. Dr. Gagner

even called down RIGHT BEFORE when I was in the OR getting my IV put in to

ask whether I really, really had to have it out! I said 'hell, yes' because

it had given me so many problems in the recent past.

Even though my surgery was described as 'textbook' and went great (lap DS

with gallbladder removal in 3 hours), Dr. Gagner was still mentioning to his

fellow surgeon, Dr. Quinn about how removing the gallbladder can

unnecessarily complicate the DS surgery and, even though removing it solo is

considered a relatively 'minor' procedure, doing it along with a DS presents

more of a challenge and risk. So, I'm sure time is a valid consideration

when considering removing the gallbladder, I think there are also some other

anatomical things as to why some surgeons prefer to do it in 'two steps' or,

do the surgery and hope that the patient will not need the 'second step' of

gallbladder removal post-op.

all the best,

lap DS with gallbladder removal

Dr. Gagner/Dr. Quinn assisting/Mt. Sinai/NYC

January 25, 2001

3 1/2 months post-op and still feelin' fab! :)

pre-op: 307 lbs/bmi 45 (5'9 " )

now: 258 lbs/bmi 38?

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In a message dated 5/14/01 11:31:59 AM, duodenalswitch writes:

<< Dr. told me she wants to get " in and out " of surgery ASAP

and does not remove the gallbladder or appendix.

>>

Actually Dr. Gagner mentioned that taking out the gallbladder during DS/WLS

is NOt the same as a gallbladder removal procedure and is much more

complicated. He prefers to not remove the gallbladder if it isn't diseased

and put the patient on Actigall to prevent stones. Studies have shown that a

certain percentage of patients will still need the gallbladder removed

sometime in the future.

Presence of stones does not necessarily necessitate gallbladder removal.

People can be totally asymptomatic and not even realize they have stones.

If, however, they have been the cause of pain, etc. then I think there is a

medical reason to indicate removal.

I had large stones (one was 1 cm!) and I pleaded and insisted that the

gallbladder be removed during my laparoscopic BPD/DS surgery. Dr. Gagner

even called down RIGHT BEFORE when I was in the OR getting my IV put in to

ask whether I really, really had to have it out! I said 'hell, yes' because

it had given me so many problems in the recent past.

Even though my surgery was described as 'textbook' and went great (lap DS

with gallbladder removal in 3 hours), Dr. Gagner was still mentioning to his

fellow surgeon, Dr. Quinn about how removing the gallbladder can

unnecessarily complicate the DS surgery and, even though removing it solo is

considered a relatively 'minor' procedure, doing it along with a DS presents

more of a challenge and risk. So, I'm sure time is a valid consideration

when considering removing the gallbladder, I think there are also some other

anatomical things as to why some surgeons prefer to do it in 'two steps' or,

do the surgery and hope that the patient will not need the 'second step' of

gallbladder removal post-op.

all the best,

lap DS with gallbladder removal

Dr. Gagner/Dr. Quinn assisting/Mt. Sinai/NYC

January 25, 2001

3 1/2 months post-op and still feelin' fab! :)

pre-op: 307 lbs/bmi 45 (5'9 " )

now: 258 lbs/bmi 38?

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In a message dated 5/14/01 11:31:59 AM, duodenalswitch writes:

<< Dr. told me she wants to get " in and out " of surgery ASAP

and does not remove the gallbladder or appendix.

>>

Actually Dr. Gagner mentioned that taking out the gallbladder during DS/WLS

is NOt the same as a gallbladder removal procedure and is much more

complicated. He prefers to not remove the gallbladder if it isn't diseased

and put the patient on Actigall to prevent stones. Studies have shown that a

certain percentage of patients will still need the gallbladder removed

sometime in the future.

Presence of stones does not necessarily necessitate gallbladder removal.

People can be totally asymptomatic and not even realize they have stones.

If, however, they have been the cause of pain, etc. then I think there is a

medical reason to indicate removal.

I had large stones (one was 1 cm!) and I pleaded and insisted that the

gallbladder be removed during my laparoscopic BPD/DS surgery. Dr. Gagner

even called down RIGHT BEFORE when I was in the OR getting my IV put in to

ask whether I really, really had to have it out! I said 'hell, yes' because

it had given me so many problems in the recent past.

Even though my surgery was described as 'textbook' and went great (lap DS

with gallbladder removal in 3 hours), Dr. Gagner was still mentioning to his

fellow surgeon, Dr. Quinn about how removing the gallbladder can

unnecessarily complicate the DS surgery and, even though removing it solo is

considered a relatively 'minor' procedure, doing it along with a DS presents

more of a challenge and risk. So, I'm sure time is a valid consideration

when considering removing the gallbladder, I think there are also some other

anatomical things as to why some surgeons prefer to do it in 'two steps' or,

do the surgery and hope that the patient will not need the 'second step' of

gallbladder removal post-op.

all the best,

lap DS with gallbladder removal

Dr. Gagner/Dr. Quinn assisting/Mt. Sinai/NYC

January 25, 2001

3 1/2 months post-op and still feelin' fab! :)

pre-op: 307 lbs/bmi 45 (5'9 " )

now: 258 lbs/bmi 38?

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My surgeon always takes out the gall bladder. However, he did state that it is a very delicate procedure when doing a switch. Just a small nick and cause bile to spill out and be very dangerous to the other exposed organs. When he removes it he cuts as far from it's base as he can to prevent accidental poking.

Mickyco-owner KoalityKare "Quality childcare isn't expensive. It's priceless."http://www.homestead.com/koalitykare/KoalityKare.html

Re: donnabert@...

In a message dated 5/14/01 11:31:59 AM, duodenalswitch writes:<< Dr. told me she wants to get "in and out" of surgery ASAP and does not remove the gallbladder or appendix. >>Actually Dr. Gagner mentioned that taking out the gallbladder during DS/WLS is NOt the same as a gallbladder removal procedure and is much more complicated. He prefers to not remove the gallbladder if it isn't diseased and put the patient on Actigall to prevent stones. Studies have shown that a certain percentage of patients will still need the gallbladder removed sometime in the future.Presence of stones does not necessarily necessitate gallbladder removal. People can be totally asymptomatic and not even realize they have stones. If, however, they have been the cause of pain, etc. then I think there is a medical reason to indicate removal. I had large stones (one was 1 cm!) and I pleaded and insisted that the gallbladder be removed during my laparoscopic BPD/DS surgery. Dr. Gagner even called down RIGHT BEFORE when I was in the OR getting my IV put in to ask whether I really, really had to have it out! I said 'hell, yes' because it had given me so many problems in the recent past. Even though my surgery was described as 'textbook' and went great (lap DS with gallbladder removal in 3 hours), Dr. Gagner was still mentioning to his fellow surgeon, Dr. Quinn about how removing the gallbladder can unnecessarily complicate the DS surgery and, even though removing it solo is considered a relatively 'minor' procedure, doing it along with a DS presents more of a challenge and risk. So, I'm sure time is a valid consideration when considering removing the gallbladder, I think there are also some other anatomical things as to why some surgeons prefer to do it in 'two steps' or, do the surgery and hope that the patient will not need the 'second step' of gallbladder removal post-op.all the best,lap DS with gallbladder removalDr. Gagner/Dr. Quinn assisting/Mt. Sinai/NYCJanuary 25, 20013 1/2 months post-op and still feelin' fab! :)pre-op: 307 lbs/bmi 45 (5'9")now: 258 lbs/bmi 38? ----------------------------------------------------------------------

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My surgeon always takes out the gall bladder. However, he did state that it is a very delicate procedure when doing a switch. Just a small nick and cause bile to spill out and be very dangerous to the other exposed organs. When he removes it he cuts as far from it's base as he can to prevent accidental poking.

Mickyco-owner KoalityKare "Quality childcare isn't expensive. It's priceless."http://www.homestead.com/koalitykare/KoalityKare.html

Re: donnabert@...

In a message dated 5/14/01 11:31:59 AM, duodenalswitch writes:<< Dr. told me she wants to get "in and out" of surgery ASAP and does not remove the gallbladder or appendix. >>Actually Dr. Gagner mentioned that taking out the gallbladder during DS/WLS is NOt the same as a gallbladder removal procedure and is much more complicated. He prefers to not remove the gallbladder if it isn't diseased and put the patient on Actigall to prevent stones. Studies have shown that a certain percentage of patients will still need the gallbladder removed sometime in the future.Presence of stones does not necessarily necessitate gallbladder removal. People can be totally asymptomatic and not even realize they have stones. If, however, they have been the cause of pain, etc. then I think there is a medical reason to indicate removal. I had large stones (one was 1 cm!) and I pleaded and insisted that the gallbladder be removed during my laparoscopic BPD/DS surgery. Dr. Gagner even called down RIGHT BEFORE when I was in the OR getting my IV put in to ask whether I really, really had to have it out! I said 'hell, yes' because it had given me so many problems in the recent past. Even though my surgery was described as 'textbook' and went great (lap DS with gallbladder removal in 3 hours), Dr. Gagner was still mentioning to his fellow surgeon, Dr. Quinn about how removing the gallbladder can unnecessarily complicate the DS surgery and, even though removing it solo is considered a relatively 'minor' procedure, doing it along with a DS presents more of a challenge and risk. So, I'm sure time is a valid consideration when considering removing the gallbladder, I think there are also some other anatomical things as to why some surgeons prefer to do it in 'two steps' or, do the surgery and hope that the patient will not need the 'second step' of gallbladder removal post-op.all the best,lap DS with gallbladder removalDr. Gagner/Dr. Quinn assisting/Mt. Sinai/NYCJanuary 25, 20013 1/2 months post-op and still feelin' fab! :)pre-op: 307 lbs/bmi 45 (5'9")now: 258 lbs/bmi 38? ----------------------------------------------------------------------

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My surgeon always takes out the gall bladder. However, he did state that it is a very delicate procedure when doing a switch. Just a small nick and cause bile to spill out and be very dangerous to the other exposed organs. When he removes it he cuts as far from it's base as he can to prevent accidental poking.

Mickyco-owner KoalityKare "Quality childcare isn't expensive. It's priceless."http://www.homestead.com/koalitykare/KoalityKare.html

Re: donnabert@...

In a message dated 5/14/01 11:31:59 AM, duodenalswitch writes:<< Dr. told me she wants to get "in and out" of surgery ASAP and does not remove the gallbladder or appendix. >>Actually Dr. Gagner mentioned that taking out the gallbladder during DS/WLS is NOt the same as a gallbladder removal procedure and is much more complicated. He prefers to not remove the gallbladder if it isn't diseased and put the patient on Actigall to prevent stones. Studies have shown that a certain percentage of patients will still need the gallbladder removed sometime in the future.Presence of stones does not necessarily necessitate gallbladder removal. People can be totally asymptomatic and not even realize they have stones. If, however, they have been the cause of pain, etc. then I think there is a medical reason to indicate removal. I had large stones (one was 1 cm!) and I pleaded and insisted that the gallbladder be removed during my laparoscopic BPD/DS surgery. Dr. Gagner even called down RIGHT BEFORE when I was in the OR getting my IV put in to ask whether I really, really had to have it out! I said 'hell, yes' because it had given me so many problems in the recent past. Even though my surgery was described as 'textbook' and went great (lap DS with gallbladder removal in 3 hours), Dr. Gagner was still mentioning to his fellow surgeon, Dr. Quinn about how removing the gallbladder can unnecessarily complicate the DS surgery and, even though removing it solo is considered a relatively 'minor' procedure, doing it along with a DS presents more of a challenge and risk. So, I'm sure time is a valid consideration when considering removing the gallbladder, I think there are also some other anatomical things as to why some surgeons prefer to do it in 'two steps' or, do the surgery and hope that the patient will not need the 'second step' of gallbladder removal post-op.all the best,lap DS with gallbladder removalDr. Gagner/Dr. Quinn assisting/Mt. Sinai/NYCJanuary 25, 20013 1/2 months post-op and still feelin' fab! :)pre-op: 307 lbs/bmi 45 (5'9")now: 258 lbs/bmi 38? ----------------------------------------------------------------------

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When I talked to Dr. Jossart about removing the gallbladder (he and

Rabkin remove both the gallbladder and the appendix) he said the best

reason is because they want to be able to tell, if anything is going

wrong, how serious it is. You can have pain after surgery and if the

gallbladder and appendix have been removed then they know it's not

that and can move past it quickly. Some people have been mis-

diagnosed and it caused very serious problems. Also, going under

more than once doubles your chance of of something wrong happening

when you go under.

Also, said the DS surgery without the removal of

gallbladder and appendix would be 3 hours. With two Dr.'s, R and J,

with the surgery and the removal of both, it's only 2 1/2 hours.

Most likely because they have a lot of experience under their belts.

They've had no deaths, and I really love hearing all their patients

talk about how great they feel, and they all have to seem to have

this " glow " about them in pictures. I trust these Dr.'s... what can

I say? :)

Donna

Dr.'s R&J

June 13th 2001

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