Jejuno-ileal Bypass Operation for the Treatment of Morbid Obesity

Abstract

Follow-up results in 36 morbidly obese patients treated with jejuno-ileal bypass are presented. The frequency of complicating associated diseases before operation was high, and early and late postoperative complications were common. Weight loss was unsatisfactory in 31%, and one third of the patients had to maintain a relatively calorie restricted diet to avoid weight gain. Reresection of the shunt in this group was associated with a further weight reduction but with increased frequency of complications. Progressive liver failure made reoperation and revision of the shunt necessary in three patients. Another patient had the shunt reversed because of intractable diarrhoea. Seventy-seven per cent of the patients were readmitted because of complications or additional surgical procedures. Most complications occurred during the first 2 years after operation and occurred predominantly in patients with the shortest segments of the small intestine in function and in patients over 40 years of age. Seven well-nourished babies were born to bypassed mothers 30–58 months after operation. The benefits of the jejuno-ileal bypass for obesity include a significant and permanent decrease in serum lipids, improved glucose tolerance, and reduction of blood pressure, particularly in preoperative hypertensive patients. Improvement in working capacity and physical ability was experienced by the majority of the patients. Improved self-esteem and emotional stability resulted in beneficial effects in the patients' social life. Good or excellent results with adequate weight loss, minor degree of diarrhoea, or easily correctable metabolic deficits were obtained in 56% of the patients. Only four patients, however, would not have had the bypass procedure again.

Key-words:

• Intestinal bypass operation
• obesity
• side effects