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~~Sami~~ *.
Jacksonville, FL
Member Since: 04/05/06
[Latest Posts]

Forgive me if this is a double post.  I haven't seen it come up... but it may have. :) http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=18065296&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Surg Obes Relat Dis. 2007 Dec 5 [Epub ahead of print]

Maintenance of weight loss in patients with body mass index >60 kg/m(2): importance of length of small bowel bypassed.

Hamoui N, Anthone GJ, Kaufman HS, Crookes PF.

Department of Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California.

BACKGROUND: It is commonly believed that weight loss after biliopancreatic diversion/duodenal switch is inversely related to the length of the alimentary limb and the common channel. However, the effect of the biliopancreatic limb length (BPL) on weight loss has received little attention. METHODS: A total of 1001 patients after biliopancreatic diversion/duodenal switch (209 men and 792 women, mean age 42 +/- 10 yr, mean body mass index [BMI] 52 +/- 9 kg/m(2)) were divided into 2 groups according to the ratio of the BPL to the total small bowel length (SBL): a BPL 45% of the SBL. The nutritional parameters and percentage of excess weight loss were compared between the 2 groups. RESULTS: In patients with a BMI of 45% of the SBL (P = NS). At 2 years, the corresponding percentages were 73.7% and 79.5% (P = NS) and, at 3 years, were 73.4% and 75.2% (P = NS). In patients with a BMI >60 kg/m(2), the corresponding percentages of excess weight loss was 56.8% versus 61.4% (P = .07) at 1 year, 62.2% versus 77.5% (P = .04) at 2 years, and 59.8% versus 77.5% at 3 years (P = .05). CONCLUSION: The results of our study have shown that amount of weight lost after biliopancreatic diversion/duodenal switch is directly related to the proportion of small bowel bypassed in patients with a BMI >60 kg/m(2). Also, the effect increased with the duration of follow-up. In less heavy patients, the BPL/SBL ratio had a minimal effect on long-term weight loss and a more pronounced effect on nutritional parameters.

PMID: 18065296 [PubMed - as supplied by publisher]

Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008.
Questions about VSG? Try sleeveguide.com


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BBoop
Kyle, TX
Duodenal Switch (02/26/08)
Member Since: 04/10/07
[Latest Posts]

Thanks Sami...that's good info to know. Betty
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m.espoir
NJ
Duodenal Switch (10/29/07)
Member Since: 04/21/07
[Latest Posts]

ok, OMG, I feel kinda dumb. I'm not, really! So, does this mean, in English, that it is more effective for weight loss to have a SHORTER common channel.....? Thanks all
"Don't expect.......Suggest." ......–The Edge
Lap Band 2/26/03---lost 80 pounds!
FAILED (Erosion/emergency removal) 4/4/07, Gained ALL weight back 8/29/07 
Approved for DS 10/09/07

DS performed successfully 10/29/07
Hernia repair and vertical TT 1/15/09
HW  SW   CW   GW       240 225 145 135

 

 

 

 

 

 

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Laura H.
Seattle, WA
Duodenal Switch (09/30/05)
Member Since: 04/08/05
[Latest Posts]

It is hard to make out but I think what it is saying is that the ratio between the Biliopancreatic limb and the Alimentary limb is important for long term maintenance in patients with higher BMIs.  It says this was less important for those with lower BMIs.  It does not mention the common channel at all so I am guessing that was not part of the study. 

Laura H.   HW=305, LW=152, GW=160-170, CW=183  
Seattle Area Duodenal Switch Meetup,
http://wls.meetup.com/90/ All are Welcome!

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moore972003
IN
Duodenal Switch (04/04/08)
Member Since: 03/28/07
[Latest Posts]

I just saw Dr. Anthone on Monday and asked him about his common channel length.  To add to what you said... He measures to get the cc length.  He takes a certain percentage, I can't remember what it is.  But his cc's seem to be longer than the average DS surgeon.  My old surgeon just did a standard 100 cc.  Dr. A's have been anywhere from 100-200, according to what he said.  I asked if he felt like a longer cc meant a slower weight loss, and he said no.  Weight loss was more related to the other parts of the surgery.   He felt with a slightly longer cc, the patient had much less trouble with nutritional difficiencies and gas and bowel issues. Or something like that!!

Mandy                                     ***See my blog for appeal info***

  

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Anne S.
Kirkland, WA
Duodenal Switch (07/31/07)
Member Since: 02/04/05
[Latest Posts]

Well, crap. I started at BMI 73.1 - this is not good news.

SW 440/ CW 294/ GW 193 (-146 lbs. so far)  
Learning about the DS? Check out my profile. It has links to descriptions, animations, scientific studies, and more. Another excellent resource is www.dsfacts.com

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KRWaters
Manteca, CA
Duodenal Switch (05/19/09)
Member Since: 06/16/04
[Latest Posts]

Anne, is that really you?. WOW!

KAREN W. 



I LOVE MY DS!!!!!

STRIVE TO BE THE BEST YOU CAN BE AND DO THE BEST THAT YOU CAN.


Check out
www.dsfacts.com  and www.duodenalswitch.com
 for all the accurate information on the great DS, and find surgeons in your area or around the country or out of the country.

I couldn't have done without all the great peeps on this board.

SW: 235.5     CW: 190    GW: 125-ish

 

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Anne S.
Kirkland, WA
Duodenal Switch (07/31/07)
Member Since: 02/04/05
[Latest Posts]

Yes, doll, it's me. I'm hiding my waddle (double ***** in this one. Don't let me fool you! LOL (Thanks, though, sweetie.)

SW 440/ CW 294/ GW 193 (-146 lbs. so far)  
Learning about the DS? Check out my profile. It has links to descriptions, animations, scientific studies, and more. Another excellent resource is www.dsfacts.com

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Blackthorne
Kirkland, WA
Duodenal Switch (09/15/05)
Member Since: 05/22/05
[Latest Posts]

What are your limb lengths?
     Four years postop.       All co-morbidities are resolved.  Lost 101lbs in 1st year.   High wt: 277 Surgery wt:  260.7  Currently:  160lbs which includes 15lbs of bounceback.

Click here to read my blog: Unicorns & Stranger Things
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Anne S.
Kirkland, WA
Duodenal Switch (07/31/07)
Member Since: 02/04/05
[Latest Posts]

Who, me?  Alimentary = 280 cm Common Channel = 75 cm No indication on Surgical Report of Biliopancreatic Limb length. At all.  When I asked my surgeon what my limb lengths were, all three of them, he said he had not removed any of my small intestine, Alimentary and CC as above, and not to worry about the BP Limb length as it didn't make any difference, since it did not absorb anything (postop) anymore. I'll go look for average small intestinal lengths online, to try to come up with an average for myownself. Looks like my surgeon did not measure it while in there.
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Blackthorne
Kirkland, WA
Duodenal Switch (09/15/05)
Member Since: 05/22/05
[Latest Posts]

Average is 500 cm.

But people can vary greatly. Some are in the 350 range (which obviously you are not, since you have 355 cm in the above numbers). Mine, on the other hand, was 800 cm. I think the longest is like 1200.

--BT
     Four years postop.       All co-morbidities are resolved.  Lost 101lbs in 1st year.   High wt: 277 Surgery wt:  260.7  Currently:  160lbs which includes 15lbs of bounceback.

Click here to read my blog: Unicorns & Stranger Things
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Anne S.
Kirkland, WA
Duodenal Switch (07/31/07)
Member Since: 02/04/05
[Latest Posts]

Surgeon said my Alimentary total length included the 75cm common channel.
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Blackthorne
Kirkland, WA
Duodenal Switch (09/15/05)
Member Since: 05/22/05
[Latest Posts]

So your alimentary limb is 205 and your common channel is 75?
     Four years postop.       All co-morbidities are resolved.  Lost 101lbs in 1st year.   High wt: 277 Surgery wt:  260.7  Currently:  160lbs which includes 15lbs of bounceback.

Click here to read my blog: Unicorns & Stranger Things
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Anne S.
Kirkland, WA
Duodenal Switch (07/31/07)
Member Since: 02/04/05
[Latest Posts]

That's what I've been led to believe by the good surgeon, yes.
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kindredspirit fl
islander, FL
Member Since: 02/03/07
[Latest Posts]

i am lost.i am bmi 68.so why is it not good news?i don't understand.i can't wait to have my DS.
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Lagniappe12
Atlanta, GA
Duodenal Switch (08/30/06)
Member Since: 11/17/05
[Latest Posts]

Good stuff, Sami!  I think a bit of the abstract got truncated or was updated.  Here is what I copied from PubMed and highlighted the sentence in question: BACKGROUND: It is commonly believed that weight loss after biliopancreatic diversion/duodenal switch is inversely related to the length of the alimentary limb and the common channel. However, the effect of the biliopancreatic limb length (BPL) on weight loss has received little attention. METHODS: A total of 1001 patients after biliopancreatic diversion/duodenal switch (209 men and 792 women, mean age 42 +/- 10 yr, mean body mass index [BMI] 52 +/- 9 kg/m(2)) were divided into 2 groups according to the ratio of the BPL to the total small bowel length (SBL): a BPL <=45% of the SBL versus a BPL >45% of the SBL. The nutritional parameters and percentage of excess weight loss were compared between the 2 groups. RESULTS: In patients with a BMI of <=60 kg/m(2), the percentage of excess weight loss at 1 year postoperatively was 66.8% for those with a BPL <=45% of the SBL and 69.3% for those with a BPL >45% of the SBL (P = NS). At 2 years, the corresponding percentages were 73.7% and 79.5% (P = NS) and, at 3 years, were 73.4% and 75.2% (P = NS). In patients with a BMI >60 kg/m(2), the corresponding percentages of excess weight loss was 56.8% versus 61.4% (P = .07) at 1 year, 62.2% versus 77.5% (P = .04) at 2 years, and 59.8% versus 77.5% at 3 years (P = .05). CONCLUSION: The results of our study have shown that amount of weight lost after biliopancreatic diversion/duodenal switch is directly related to the proportion of small bowel bypassed in patients with a BMI >60 kg/m(2). Also, the effect increased with the duration of follow-up. In less heavy patients, the BPL/SBL ratio had a minimal effect on long-term weight loss and a more pronounced effect on nutritional parameters. --- To calculate the ratio you divide your biliopancreatic limb length by your total small bowel length.  My BPL is 510cm, SBL is 760cm for a ratio of 0.671 or 67.1 %.  My starting BMI was 71 so that bodes well for me ... according to this study, anyway. 

516.6/
232.2/180- 284.4 lbs down!

Duodenal Switch - 8/30/2006 - Dr. Marchesini
My Blog | Lab Rat Data | DuodenalSwitch.com

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LeaAnn
Huntsville, AL
Duodenal Switch (11/28/05)
Member Since: 10/19/03
[Latest Posts]

I wish you technical geniuses would tell me what this says in layman's terms.  I can't be bothered even TRYING to read that gobbledy-goop!  hehe!
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Lagniappe12
Atlanta, GA
Duodenal Switch (08/30/06)
Member Since: 11/17/05
[Latest Posts]

I believe what it's saying is that for DSers with BMI's over 60 and who have more than 45% of their small bowel bypassed, the greater the loss and a higher rate of maintaining that loss over time.  In an indirect way, it's also saying that you really have to look beyond the length of your common channel... I think.

516.6/
232.2/180- 284.4 lbs down!

Duodenal Switch - 8/30/2006 - Dr. Marchesini
My Blog | Lab Rat Data | DuodenalSwitch.com

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Kim H.
Ottawa, Canada
Duodenal Switch (02/22/08)
Member Since: 10/18/07
[Latest Posts]

I too was struggling with this report. When I went to see Dr. Lu last week he did some mathematical calculation and I believe he said my cc would be 78. Is this good or bad?

HW 265/ SW 250/ GW 140/ CW 120
REACHED GOAL IN 8 MONTHS WITH MY DS!!!  DS RENEGADE...PAY IT FORWARD!!!!!!!!
FEB.22/ 08>> DS & JAN.23/ 09>> Breast Lift, Fleur de lys abdominoplasty, hernia repair

WORKING ON MY 1ST YEAR MAINTAINING GOAL!!!
Praise the Lord 'n Pass the Protein.....Gawd I love my DS

Click here to learn more about Duodenal Switch...
DS Facts 

 

 

    
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LeaAnn
Huntsville, AL
Duodenal Switch (11/28/05)
Member Since: 10/19/03
[Latest Posts]

Sounds GOOD to me!  I love my 75 cm cc!
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m.espoir
NJ
Duodenal Switch (10/29/07)
Member Since: 04/21/07
[Latest Posts]

my cc is 85cm. I dont even know what the alimentary thing is!!! : (
"Don't expect.......Suggest." ......–The Edge
Lap Band 2/26/03---lost 80 pounds!
FAILED (Erosion/emergency removal) 4/4/07, Gained ALL weight back 8/29/07 
Approved for DS 10/09/07

DS performed successfully 10/29/07
Hernia repair and vertical TT 1/15/09
HW  SW   CW   GW       240 225 145 135

 

 

 

 

 

 

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BuckeyeSylvia
Small Town, OH
Duodenal Switch (01/10/08)
Member Since: 09/26/07
[Latest Posts]

Thanks for posting this research.  I've reposted it for someone who might need it on the insurance forum (hope that's OK...this guy needs to read this!)

HW/SW/CW/GW    231/225/123/130-125
~Surgeon's Goal of Normal BMI reached at 6 months Post Op~
~Personal Goal Range achieved at less than 10 months Post Op~

  

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