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Complications of Jejunoileal Bypass for Morbid Obesity

Complications of Jejunoileal Bypass for Morbid Obesity Abstract Fifty-two patients had jejunoileal bypass surgery. End-to-end (Scott) or end-to-side (Payne) shunts were randomly selected for each patient; 31 standard length shunts and 21 shortened bypasses were performed. Only 22 patients had an acceptable result, whereas 30 patients had inadequate weight loss (less than 2.3 kg [5 lb] per month per year) or had gastrointestinal tract, metabolic, or surgical complications judged severe enough to render the outcome less than adequate. There was one death, and four patients required reanastomosis of the bypass. The primary determinant of success was age, ie, younger patients had clearly better results than older patients. In general, shorter shunts produced more weight loss than standard bypass procedures, but were associated with an increased complication rate. Three new complications of jejunoileal bypass are reported: acute colonic dilation with necrosis, beriberi, and lupus erythematosus. References 1. Gubner R: Overweight and health: Prognostic realities and therapeutic possibilities , in Lasagna L (ed): Obesity: Causes, Consequences and Treatment . New York, Medcom Press, 1974, pp 7-25. 2. Health implications , in Obesity and Health . Arlington, Va, US Public Health Service, National Center for Chronic Diseases Control, 1968, pp 23-32. 3. Solow C, Silberfab PM, Swift K: Psychosocial effects of intestinal bypass surgery for severe obesity . N Engl J Med 290:300-303, 1974.Crossref 4. Payne JH, DeWind L, Schwab CE, et al: Surgical treatment of morbid obesity . Arch Surg 106:432-437, 1973.Crossref 5. Scott HW, Dean R, Shull HJ, et al: New considerations in use of jejunoileal bypass in patients with morbid obesity . Ann Surg 177:723-733, 1973.Crossref 6. Salmon PA: The results of small bowel intestinal bypass operations for the treatment of obesity . Surg Gynecol Obstet 132:965-979, 1971. 7. Moxley RT, Pozefsky T, Lockwood DH: Protein nutrition and liver disease after jejunoileal bypass for morbid obesity . N Engl J Med 290:921-926, 1974.Crossref 8. McGill DB, Humphrey SR, Baggenstoss AH: Cirrhosis and death after jejunoileal bypass . Gastroenterology 63:872-877, 1972. 9. DeMuth WE Jr, Rottenstein HS: Death associated with hypocalcemia after small bowel bypass . N Engl J Med 270:1239-1240, 1964.Crossref 10. Williams HE: Nephrolithiasis . N Engl J Med 290:33-38, 1974.Crossref 11. Printen KJ, Mason EE: Gastric surgery for relief of morbid obesity . Arch Surg 106:428-431, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Complications of Jejunoileal Bypass for Morbid Obesity

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360140183036
Publisher site
See Article on Publisher Site

Abstract

Abstract Fifty-two patients had jejunoileal bypass surgery. End-to-end (Scott) or end-to-side (Payne) shunts were randomly selected for each patient; 31 standard length shunts and 21 shortened bypasses were performed. Only 22 patients had an acceptable result, whereas 30 patients had inadequate weight loss (less than 2.3 kg [5 lb] per month per year) or had gastrointestinal tract, metabolic, or surgical complications judged severe enough to render the outcome less than adequate. There was one death, and four patients required reanastomosis of the bypass. The primary determinant of success was age, ie, younger patients had clearly better results than older patients. In general, shorter shunts produced more weight loss than standard bypass procedures, but were associated with an increased complication rate. Three new complications of jejunoileal bypass are reported: acute colonic dilation with necrosis, beriberi, and lupus erythematosus. References 1. Gubner R: Overweight and health: Prognostic realities and therapeutic possibilities , in Lasagna L (ed): Obesity: Causes, Consequences and Treatment . New York, Medcom Press, 1974, pp 7-25. 2. Health implications , in Obesity and Health . Arlington, Va, US Public Health Service, National Center for Chronic Diseases Control, 1968, pp 23-32. 3. Solow C, Silberfab PM, Swift K: Psychosocial effects of intestinal bypass surgery for severe obesity . N Engl J Med 290:300-303, 1974.Crossref 4. Payne JH, DeWind L, Schwab CE, et al: Surgical treatment of morbid obesity . Arch Surg 106:432-437, 1973.Crossref 5. Scott HW, Dean R, Shull HJ, et al: New considerations in use of jejunoileal bypass in patients with morbid obesity . Ann Surg 177:723-733, 1973.Crossref 6. Salmon PA: The results of small bowel intestinal bypass operations for the treatment of obesity . Surg Gynecol Obstet 132:965-979, 1971. 7. Moxley RT, Pozefsky T, Lockwood DH: Protein nutrition and liver disease after jejunoileal bypass for morbid obesity . N Engl J Med 290:921-926, 1974.Crossref 8. McGill DB, Humphrey SR, Baggenstoss AH: Cirrhosis and death after jejunoileal bypass . Gastroenterology 63:872-877, 1972. 9. DeMuth WE Jr, Rottenstein HS: Death associated with hypocalcemia after small bowel bypass . N Engl J Med 270:1239-1240, 1964.Crossref 10. Williams HE: Nephrolithiasis . N Engl J Med 290:33-38, 1974.Crossref 11. Printen KJ, Mason EE: Gastric surgery for relief of morbid obesity . Arch Surg 106:428-431, 1973.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1975

References