Change of Bile Acid Metabolism and Absorption of Vitamin B₁₂ after Intestinal Shunt Operation in Obesity

Abstract

Danö, P. & Lenz, K. Change of bile acid metabolism and absorption of vitamin B₁₂ after intestinal shunt operation in obesity. A comparison of three types of operation. Scand. J. Gastroent. 1974, 9, 159-165.

An intestinal shunt operation for obesity was made in 33 patients. Three types of operation were compared. Type I: 36 cm of proximal jejunum anastomosed end-to-side to 12 cm terminal ileum. Type II: 24 cm jejunum + 24 cm ileum. Type III: 12 cm jejunum + 36 cm ileum. After the operation we found a statistically significant increase of the glycine/taurine ratio in jejunal contents and of the transfer of glycine conjugates to the colon (abnormal ‘breath test’). There was a significant decrease of the bile acid concentration in the jejunum and of the absorption of vitamin B₁₂. As regards the abnormal breath test and diminished vitamin B₁₂ absorption, the results in type III-operated patients deviated significantly less from normal values than the results in patients with type I or II-operations. The study favours the choice of a type III-operation which preserves the longest segment of terminal ileum.

Key-words::

• Bile acids
• by-pass operation
• obesity
• vitamin B₁₂