BPD vs. BPD/DS

[Guest guest]

Honestly, in all my research and reading and experiences, the BPD and

the DS are NOT lightyears apart. The DS is a *modification* to the

original BPD. It's a very complex modification to perform surgically.

I can understand a surgeon looking at the Scopinaro BPD and at the

BPD/DS and deciding that the differences between them are not worth

the cost-benefit difference to the surgeon *or* to the patient.

Patients may feel differently. They may not.

Admittedly, I have a bias. I don't like to see the BPD put down or

surgeons or patients who feel that the DS is automatically and

comprehensively superior to the BPD. They are VERY similar surgeries

with very similar average outcomes. >>>>>

Sharon: I'm glad you spoke out and told about your experience with the BPD.

Obviously, it is a *modification* meant to improve various *possible* side

effects and post-op experiences of the BPD surgery. It is not a radically

different surgery. Basically the stomach portion was redesigned and a

section of duodenum remained intact before the BPD occurs. Then, the common

channel was lengthened (in most cases more than 50 cm) to maximize post-op,

long term absorption. Certainly, not everyone would experience any or all of

these negative effects of the DS. Same goes for the DS. I obviously have a

bias for the DS since I had such an outstanding outcome -- virtually no

negative side effects (other than a few episodes of bad gas --- one of which

lately involved my IBS/Spastic colon more than the actual surgery, I

suspect). I am able to eat whatever I want and really haven't had terrible

side effects except early post-op and with some artificially

flavored/preserved foods (which I try to eat sparingly anyway).

However, statistically speaking, studies have shown that the traditional BPD

carried more of a nutritional risk. This is not to say that the DS does not

involve possible nutritional deficiencies. I know that you experienced a few

of these (and you may well have experienced them had you had the DS, too).

Of course, I don't think patients should choose merely based on individual

testimonies -- Although our experiences are totally valid and meaningful, the

surgeons who have spoken out on the DS being preferable are basing their

statements on studies that have been done. It's not just an issue of patient

preference. I don't think their purpose is to bad mouth the BPD or say it is

a 'bad' surgery. They are saying that statistics have shown (and these are

based on a wide variety of patient experiences) that the DS does indeed

involve notable improvements over the BPD.

The concern voiced here is that the surgeons who are making such decisions

(stating that the BPD doesn't really have many advantagse over the DS and

should be performed instead since the DS involves a higher surgical

complexity) are doing so in spite of the statistics and studies that have

been done comparing the BPD and DS. Now, if there are new studies out there

or new information that can and do back up their claims that there is little

difference, then I think they have the responsibility to make these public

and perhaps a re-evaluation of the importance of the DS improvements vis a

vis the complexity of the surgery can occur.

To say that patients 'overvalue the pyloric valve' or that it doesn't always

'work' without substantiating these statements (especially in light of

documented studies that state otherwise) is rather perplexing and misleading,

IMHO. Once again, it makes it sound like DS is simply a matter of 'patient

preference' when in fact the surgical community has well documented the

benefits of the DS and have unequivocally stated that it would be preferred

for various reasons. This preference does not mean that the BPD is a bad

surgery but that the DS was designed to address certain nutritional

deficiences and side effects that many post-op BPDers experienced. STudies

conducted to compare the two surgeries have shown that, overall, the changes

HAVE actually resulted in a lessening of such side effects and deficiencies.

This is not to say that the DS is totally 'risk free' or that Dsers won't

experience negative side effects, of course.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. gagner/Mt. Sinai/NYC

nine months post-op and still feelin' fabu!

preop: 307 lbs/bmi 45

now: 207 (yipee!)