Re: : Re: Surgeon switching back to Scorpinaro

[Guest guest]

In a message dated 10/19/01 10:51:28 PM, duodenalswitch

writes:

<<

This will still be lap. And my surgeon is ! She gave me

very good arguments...

>>

wow, this is really interesting. There is another surgeon here in NYC (Dr.

Ren) who is doing exactly the same thing. Both surgeons studied under Dr.

Gagner at Mt. Sinai, too.

I don't know if the risks of pancreatitis are increased with the sleeve

gastrectomy, but I DO KNOW that there is an increased risk of pancreatic

cancer with removal of the antreum (lower stomach, as with the BPD). This is

indicated by studies done on peptic ulcer patients who had the lower stomach

removed (that is the acid producing area). I did send all kinds of info and

links on this issue when I researched it before my surgery -- it is all in

the archives here if you do a search. It would be under my screenname

(ruisha) and most likely with the title gastric/pancreatic cancer or

something like that.

So, please please -- ask her about those studies done with peptic ulcer

patients. Dr. Gagner verbally confirmed that there is an increased risk of

pancreatic cancer with removal of the antreum, but NOT with the sleeve

gastrectomy when I addressed this issue with him before my surgery.

Did the surgeon go over the cons as well as her pros when discussing the

traditional BPD? I really don't know where the ulcer issue comes from... I

had heard there is an increased risk of ulcers with an RNY but NOT a DS. It

would really ennervate me if she is only talking about the pros of the BPD

(and some of those I'd really, really ask for hard evidence on since I

really, honestly have NOT heard of them) and not discuss the possible side

effects!

I'm not saying that everyone who has a BPD will develop pancreatic cancer.

However, this link HAS been established (in research on peptic ulcer patients

-- and remember, all WLS surgeries originated from gastric surgeries such as

these, so the evidence for gastric surgeries preceeds and may have more

information than the evidence out there for the WLS itself because it is

relatively 'new' and there have been less studies conducted on it). It would

be extremely irresponsible, IMHO, for a surgeon to not even inform the

patient of risks involved, however small or insignificant the surgeon may (or

may not) view them.

When were you informed of this 'switch' in her technique? I would be quite a

bit on edge if I were informed just a few days before surgery that I would be

gettting a different surgery than I had anticipated. If I had had more time

to consider the options, etc. then I would feel more confident. However, if

this were a rather 'last minute' decision I would feel quite pressured into

accepting things and not doing any more research on my own or demanding

further evidence from the surgeon.

I wish you the absolute best, Leanne! I know you've been through so much

trying to get approval, finding a surgeon and also with the diabetes

diagnosis! Let us know how everything goes. Is there any way you can

reschedule the surgery for a week or two after? Then, you could research and

have enough time to consider this new change (if indeed did NOT

provide much time beforehand). I am always extremely leary of surgeons who

'bait and switch' right before the surgery. To me, it is inconsiderate and

puts an already stressed-out patient at the mercy of the medical

establishment when they should have sufficient time to consider this decision

that will affect their future.

If you DO decide on the BPD, ask what kind of aftercare would be mandatory to

detect for pancreatic cancer. It's symptoms mimic many gastric complaints of

a DS post-op, so it may be difficult to catch in the earliest stages. I

would DEMAND proper aftercare and diagnosis and a formal statement that you

are at increased risk so your PCP will get you ALL the appropriate testing,

etc. to help in post-op life!

All the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC