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Post by callmeEJ on Jan 7, 2012 18:53:32 GMT -5
As you can see from my sig, I'm a little over a year out. My weight loss has been a bit on the slow side, which I have mostly been attributing to the fact that I take anti-depressants and my inability to get as much water as I really should be drinking. That and I haven't really been exercising much.
I was filing a bunch of papers today, and was looking at my operative report from my DS. I haven't looked at it all since a coupe months after my DS. My common channel is 75cm, my bilio-pancreatic limb is 50 cm, and apparently my alimentary limb is 550 cm. Is this an overly long AL length? Am I being paranoid? It's ok to tell me I'm being paranoid, I can take it. ;D
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Post by fullhousemom on Jan 7, 2012 19:12:07 GMT -5
Sometimes the terminology differs between doctors. My common channel is 95 cm. My alimentary limb is 200, for a post-DS length of 295 cm. My pre-DS length was 770 cm.
An alimentary limb of 550 cm is by far the largest I have ever seen posted in the boards. Are you sure that is a post measurement? Something doesnt sound right.
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Post by Deleted on Jan 7, 2012 19:16:54 GMT -5
I would call Buchwald's office and ask him to confirm this. This does NOT sound right. Most of us have 50-60% of our pre-op small intestine in our biliopancreatic limb.
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Post by callmeEJ on Jan 7, 2012 19:25:23 GMT -5
Well, now that I read it closely, I'm not so sure. Maybe I spoke too soon.
From the first part of the report:
"Procedures performed: 1) Open duodena switch with 75 cm common channel two 25 cl biliary pancreatic limb and twenty 25 cm alimentary limb.
2) Sleeve gastrectomy"
But, from where they describe the procedure, it says:
"...At this point, a 75 cm of common channel from the ileocecal valve was marked using stay sutures and the remaining 450 cm of valve was divided equally to alimentary limb and biliary pancreatic limb using a GIA stapler with a blue load...."
I have no idea. Sounds like I should confirm w/ Dr. B, and soon.
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Post by Joanne on Jan 7, 2012 19:28:30 GMT -5
I agree with the others, that doesn't sound right. To answer your question, we tend to focus on the Common Channel limb length as it relates to weight loss, because that's where fat digestion takes place. But I believe other digestion (ie protein) does take place in the alimentary limb, so having more of it would matter. 550 CM would be an exceptionally long amount. Some surgeons include the length of the CC when discussing alimentary limbs, but that would still be long. I'd call the surgeon and ask.
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Post by Dudette on Jan 7, 2012 19:35:45 GMT -5
"...At this point, a 75 cm of common channel from the ileocecal valve was marked using stay sutures and the remaining 450 cm of valve was divided equally to alimentary limb and biliary pancreatic limb using a GIA stapler with a blue load...." I have no idea. Sounds like I should confirm w/ Dr. B, and soon. Those measurements sound really close to what's on my report. I have a 200cm alimentary limb and a 250cm biliopancreatic limb (450cm total just like you) with a 100cm common channel. Just FYI... |
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Post by Deleted on Jan 7, 2012 19:44:43 GMT -5
Sounds to me like a crappy transcriptionist.
I get from what you typed:
CC: 75 cm
Alimentary: 225 cm
Biliopancreatic: 225 cm
That sounds normal.
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Post by RedSkittles on Jan 7, 2012 22:36:49 GMT -5
Yes, it can affect weight loss because the actual cells of the intestine can secrete enzymes that break down food a bit and lead to more absorption.
Buchwald patients do seem to have more trouble getting to goal than some other surgeons' patients, but that can lead to fewer vitamin and food tolerance issues, on the positive side.
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Post by sherbearmama on Jan 8, 2012 1:08:00 GMT -5
These were the numbers I got from my surgeon--I asked him the numbers, he read them aloud, but I didn't actually see it for myself on paper. If I wrote it all correctly this is what I found:
I had a 400 length intestines (I think that's pre op),
240 Biliopancreatic,
160 alimentary limb
100 common channel
Diana (and any other vets out there, does this sound normal? He said he was conservative but I hope he wasn't TOO conservative. If these numbers sound off, I'll email his physicians assistant to get it all in writing so I can make sure I got it right.
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Post by sherbearmama on Jan 8, 2012 1:12:27 GMT -5
Oh, and if my measurements are correct, then how will this affect my weight loss?
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Post by hoosiermama on Jan 8, 2012 1:33:35 GMT -5
I don't know any of my numbers but it seems it would be helpful to find out what each of these does.
This is how I understand it, please correct me if I'm wrong.
The bileopancreatic limb holds all the digestive bile. No food goes into this channel.
The alimentary limb transports the food down to the common channel. Could someone clarify what this limb helps to digest and where fat gets digested?
The common channel is where the two limbs join and the food mixes with the bile on it's way to the large intestine or bowel.
Also, I thought I read somewhere that the average small intestine was 700 cm long. That doesn't work with any of these measurements. Anyone help me understand?
Is this right?
me
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Post by hoosiermama on Jan 8, 2012 10:26:49 GMT -5
we need slim shady  Ohhhh Slimmmmmm yooooo hooooo |
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Post by hoosiermama on Jan 8, 2012 13:59:30 GMT -5
Didn't know. Someone has to know this stuff...where is(was) fat absorbed...where is our 20 percent absorbed....
me
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Post by Deleted on Jan 8, 2012 14:20:47 GMT -5
Didn't know. Someone has to know this stuff...where is(was) fat absorbed...where is our 20 percent absorbed.... me Fats require digestive juices to digest. Therefore the fats we eat are absorbed primarily in the common channel. This is why the % of fats absorbed is so low. By the way, the 20% figure is just the average. It will vary somewhat from person to person. |
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Post by Deleted on Jan 8, 2012 14:21:49 GMT -5
Well I think it is all absorbed in the CC. A ittle might be absorbed in the AL, I suppose...but none of it can be absorbed in the BL because there is no food there, right? LOL VETS!! Where are YOUUUU! Right, no food is in the biliopancreatic limb at all. |
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Post by Deleted on Jan 8, 2012 14:22:58 GMT -5
Slim has left the building.  Slim has left?!? Oh, that's disappointing. I know his life got extremely busy with a recent job change and relocation. I hope he and Rags will come back when things settle. |
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Post by Deleted on Jan 8, 2012 14:28:07 GMT -5
Pretty much all of the fat (except free fatty acids) in our food is absorbed in the common channel, because it requires the presence of bile to solublize the fat, and lipases to break it down to make it absorbable (and/or dissolved in bile, which is taken up by the gut as well). Sugars are absorbed 100% because they are already in a form that can be absorbed. Protein and complex carbs are absorbed to some extent in the alimentary tract, because there are SOME enzymes present in that part of the gut that can break them down to amino acids and sugars, respectively. But the pancreatic enzymes that are only delivered to the common channel are required for optimum efficiency, so a good deal more absorption of the protein and complex carbs occurs in the common channel. Both the RNY and the DS have a Roux-en-Y intestinal configuration, but with different limb lengths and portions included. Roux-en-Y means ... a surgically created (end-to-side) anastomosis. Typically, it is between small bowel and small bowel that is distal (or further down the gastrointestinal tract) from the cut end. ...
The name is derived from the surgeon who first described it (César Roux) and the stick-figure representation. Diagramatically, the Roux-en-Y anastomosis looks like the letter Y; typically, the two upper limbs of the Y represent a proximal segment of small bowel and the distal small bowel it joins with (which is often a blind end), and the lower part of the Y the distal small bowel (beyond the anastomosis).
Roux-en-Ys are used in several operations and collectively called Roux operations
en.wikipedia.org/wiki/Roux-en-Y_anastomosis |
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Post by hoosiermama on Jan 8, 2012 15:23:54 GMT -5
Thanks all for the info. REALLY dumb question. Where do our vitamins absorb? Do they require the bile or does stomach acid handle that or is it dependent on the vitamin?
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Post by callmeEJ on Jan 8, 2012 15:41:18 GMT -5
Sounds to me like a crappy transcriptionist. That is my hope! Ugh, I hate feeling like a worrywart. |
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Ohhhh Slimmmmmm yooooo hooooo
