Post Date: 6/22/08 12:33 pm Not only is there a high risk of the gall bladder getting stones (and the PAIN and risk of pancreatitis attendent to gall stones), but after the DS, there is NO POINT to having one. The gall bladder stores bile produced by the liver, so that it can be released in a bolus in response to high fat meals to help digest the fat. This was very important as humans (and other carnivores) were evolving, because meat meals rely on hunting, and there were long periods of no meat punctuated by gorging on a kill to eat it before it rots. Obviously, this is NOT how we eat now.
After the DS, our bile is kept separate -- deliberately -- from the alimentary tract. It (and the pancreatic enzymes) dribbles down the biliopancreatic limb to join whatever food it happens to meet at the common channel. I don't believe the gall bladder even gets the signals from eating a high fat meal after the DS, because those are triggered by receptors in the portion of the gut that is no longer in the alimentary tract, and thus the food can't trigger the receptors. Therefore, the gall bladder has NO PURPOSE for DSers, and is only a potential source of problems.
I too questioned Dr. Rabkin about why he would need to remove a perfectly healthy organ, should he find that mine was healthy. He explained the above, and I agreed. I was kind of hoping he would find that I had sludge in my gall bladder which would explain the several bouts of severe gut pain I had had over the years -- but nope, he removed a perfectly healthy gall bladder. Apparently, the pain I had was IBS. But I haven't missed my gall bladder one bit.
As for the appendix, it doesn't have a purpose in the first place, so removal with ANY abdominal surgery is routine. In fact, I had had three previous abdominal surgeries before my DS, and in two of them (they didnt' bother during the C-section), the surgeons had TRIED to remove my appendix and had been unable to find it. In fact, the second surgeon told me my appendix had obviously been removed during the first surgery, because he had seen the scar! Well, I knew that wasn't true (unless it was when I was abducted by aliens!) -- I had even been diagnosed with appendicitis in my early 40s, which had resolved without surgery. Then when I had a barium enema study (trying to diagnose my IBS), it clearly showed my appendix -- in a very unusual position. Insteaad of being at the junction of my small intestine and colon in the lower right quadrant, it was up much further and on the back side of my colon, up under my liver -- a retrocoecal appendix. So when I had my DS, I brought the Xrays of the barium study to Rabkin so he could track it down and remove it, finally. It took him an extra hour plus in surgery, plus two extra lap holes to reposition the instruments to get it, but I finally had it out.
In addition to the reasons above, not having a gall bladder or appendix simplifies the differential diagnosis of belly pain for us DSers -- we have enough complicated reasons for belly pain that are out of the ordinary, including adhesions, kinked bowels, Peterson's hernias and issues with blockages in the biliopancreatic limb which do not have the expected symptoms of intestinal blockages (because we can still poop and fart with a biliopancreatic bowel blockage, since it is not in the alimentary tract) that being able to rule out two common causes of belly pain is important to make the proper diagnosis more quickly.