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Re: Reversibility of DS

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In a message dated 11/24/01 11:27:06 PM, duodenalswitch

writes:

<< The only DS reversals I am aware of were due to alcoholism. Rabkin

reversed one for that reason, and I saw in an earlier post here that

Baltasar did too.

I have never heard of a DS patient needing a reversal due to a failure

of the surgery, and I have been in contact with hundreds of DS post-ops

over the past few years. I just had to reformat the Hess Report page of

the DS website due to a technical problem, and while I was working on

the page, I was reminded again how much great information there is

there!

>>

: Thanks for the clarification on this -- I do recall reading

something to this effect (alcoholism causing liver damage, etc. in a post-op

DS patient) as being a reason for reversal (of the intestinal portion, of

course).

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

almost 10 months post-op and still feelin' fabu

preop: 307 lbs/bmi 45

now: 204 lbs (up again!)/size sweet 16/large-MEDIUM in normal people's

clothing!

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Hi All,

Regarding reversals/revisions of the intestinal portion of the DS:

these do occur in 1-3% of the cases. As Theresa mentioned, Alcoholism

and drug abuse play a major role. Another reasons for revision is

anerexia. Revision or reversal is much more prevelent among women

then men (women are 4x more likely according to a study by Clare).

Occasionally a revision/reversal is necessary due to excess weight

loss. This excess weight loss is usually accompanied by protien

malnutrion. Joe Frost would be a case and point.

Some surgeons will revise the common and/or alimentary channel

lengths (i.e. Hess). Dr. Anthone preferes a full anatomical reversal

of the intestinal part of the procedure.

Hull

>

> In a message dated 11/24/01 11:27:06 PM, duodenalswitch@y...

> writes:

>

> << The only DS reversals I am aware of were due to alcoholism.

Rabkin

> reversed one for that reason, and I saw in an earlier post here that

> Baltasar did too.

>

> I have never heard of a DS patient needing a reversal due to a

failure

> of the surgery, and I have been in contact with hundreds of DS post-

ops

> over the past few years. I just had to reformat the Hess Report

page of

> the DS website due to a technical problem, and while I was working

on

> the page, I was reminded again how much great information there is

> there!

> >>

>

> : Thanks for the clarification on this -- I do recall

reading

> something to this effect (alcoholism causing liver damage, etc. in

a post-op

> DS patient) as being a reason for reversal (of the intestinal

portion, of

> course).

>

> all the best,

>

> lap ds with gallbladder removal

> January 25, 2001

> Dr. Gagner/Mt. Sinai/NYC

>

> almost 10 months post-op and still feelin' fabu

>

> preop: 307 lbs/bmi 45

> now: 204 lbs (up again!)/size sweet 16/large-MEDIUM in normal

people's

> clothing!

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> Why would you have to reverse a DS due to alcoholism?

I'm not exactly sure. I just know that Dr. Rabkin's published report

mentions that reversal due to alcoholism. Must have something to do with

overstressing the liver though, I'm guessing. I'll ask Dr. Rabkin and

see if I can find out more. I'll let you know what I find out.

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In a message dated 11/26/01 11:19:27 AM, duodenalswitch

writes:

<< I'm not exactly sure. I just know that Dr. Rabkin's published report

mentions that reversal due to alcoholism. Must have something to do with

overstressing the liver though, I'm guessing. I'll ask Dr. Rabkin and

see if I can find out more. I'll let you know what I find out.

>>

Yeah, I think that's what it is -- the development of fatty liver (in the

extreme) due to alcoholism. It can get pretty serious if it reaches those

proportions... Let us know what Dr. Rabkin says.

all the best,

TEresa

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

10 months post-op and still feelin' fabu

preop: 307 lbs/bmi 45

now: 204 lbs (gained - yuck!)/size sweet 16/large-MEDIUM in normal people's

clothing!

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> > Why would you have to reverse a DS due to alcoholism?

>

> I'm not exactly sure. I just know that Dr. Rabkin's published

> report mentions that reversal due to alcoholism. Must have

> something to do with overstressing the liver though, I'm guessing.

> I'll ask Dr. Rabkin and see if I can find out more. I'll let you

> know what I find out.

Here's what I found out. Without knowing specifics about the particular

case, the answer seems to be that alcohol and drug abusers can become

noncompliant, failing to eat right, take their supplements and get their

followups. If a person can't be relied upon to take proper care of

themselves after the DS, then the best recourse is to reverse things in

order to eliminate the malabsorption.

M.

---

in Valrico, FL, age 39

Lap DGB/DS by Dr. Rabkin 10/19/99

Starting weight 299, now 153

Starting BMI 49.7, now 25.5

Starting size 26/28, now 10/12

http://www.duodenalswitch.com/Patients/M/melaniem.html

Direct replies: mailto:melanie@...

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Alcoholism can cause liver damage and eventually liver failure even

in people who are binge drinkers and continue to eat fairly well most

of the time. So there are probably many reasons to reverse a DS for

an active alcoholic. Unfortunately the liver damage from alcohol

generally does not show up in lab tests until there is only about 5%

of the liver left functioning. And one of the telling tests is the

albumin level, which typically gets too low as it does with protein

malabsorption and inadequate protein intake.

I have had one post WLS patient who was an alcoholic and he had an

old JIB which was reversed due to liver failure. He's on the

transplant waiting list now. Lots of fun I had trying to prescribe

for him. LOL

/Seattle

> > > Why would you have to reverse a DS due to alcoholism?

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