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Jejunoileal Bypass: A Legacy of Late Complications

Jejunoileal Bypass: A Legacy of Late Complications Abstract • Since 1977, we have managed 56 patients (36 Payne and 20 Scott bypasses) with late (one to 18 years) complications resulting from a jejunoileal bypass. All patients underwent a one-stage conversion of the jejunoileal bypass to a gastric bypass. Patients were classified according to (1) postbypass weight, (2) the need for nutritional support, (3) the type and severity of complication, and (4) the time interval between jejunoileal bypass and the onset of the complication and correction of the complication. There were no operative deaths; one patient died 18 months after surgery of cirrhosis. The complication rate was 34%; however, most complications were minor. Our experience with this procedure has shown it to be highly effective in correcting complications other than polyarthritis. When coupled with nutritional support, it is safe even in malnourished patients. (Arch Surg 1987;122:610-614) References 1. Kirkpatrick JR: Nutrition and Metabolism in the Surgical Patient . Mt Kisco, NY, Futura Publishing Co, 1983, pp 485-486. 2. Payne JH, DeWind LT, Commons RR: Metabolic observations in patients with jejunocolic shunts . Am J Surg 1963;106:273-289.Crossref 3. Payne JH, DeWind LT: Surgical treatment of obesity . Am J Surg 1969;118:141-147.Crossref 4. Scott HW Jr, Law DH IV, Sandstead HH, et al: Jejunoileal shunt in surgical treatment of morbid obesity . Ann Surg 1970;171:770-782.Crossref 5. Bray GA, Barry RE, Benfield JR, et al: Intestinal bypass operation as a treatment for obesity . Ann Intern Med 1976;85:97-105.Crossref 6. Halverson JD, Gentry K, Wise L, et al: Reanastomosis after jejunoileal bypass . Surgery 1978;84:241-249. 7. Starkloff GG, Donovan JJ, Ramach KR, et al: Metabolic intestinal surgery, its complications and management . Arch Surg 1975;110:652-656.Crossref 8. Scott HW, Dean R, Shull JH, et al: New consideration in use of jejunoileal bypass in patients . Ann Surg 1973;177:723-735.Crossref 9. Buchwald H, Varco RL, Moore RB, et al: Intestinal bypass procedures . Curr Probl Surg , (May) 1975, pp 1-51. 10. Griffen WO Jr, Bivins BA, Bell RM: The decline and fall of the jejunoileal bypass . Surg Gynecol Obstet 1983;157:301-308. 11. Yates BT: Survey of 3146 patients receiving jejunoileal or gastric bypass . Am J Clin Nutr 1980;33:518-522. 12. Andersen T, Juhl E, Quaade F: Jejunoileal bypass: What can we learn from a literature study? Am J Clin Nutr 1980;33:440-445. 13. Hitchcock CT, Jewell WR, Hardin CA, et al: Management of the morbidly obese patient after small bowel bypass failure . Surgery 1977;82: 356-361. 14. Griffen WO Jr, Hostetter JM, Bell RM, et al: Experiences with conversion of jejunoileal bypass procedures for morbid obesity . Ann Surg 1977;186:500-509.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Jejunoileal Bypass: A Legacy of Late Complications

Archives of Surgery , Volume 122 (5) – May 1, 1987

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References (18)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1987.01400170116017
Publisher site
See Article on Publisher Site

Abstract

Abstract • Since 1977, we have managed 56 patients (36 Payne and 20 Scott bypasses) with late (one to 18 years) complications resulting from a jejunoileal bypass. All patients underwent a one-stage conversion of the jejunoileal bypass to a gastric bypass. Patients were classified according to (1) postbypass weight, (2) the need for nutritional support, (3) the type and severity of complication, and (4) the time interval between jejunoileal bypass and the onset of the complication and correction of the complication. There were no operative deaths; one patient died 18 months after surgery of cirrhosis. The complication rate was 34%; however, most complications were minor. Our experience with this procedure has shown it to be highly effective in correcting complications other than polyarthritis. When coupled with nutritional support, it is safe even in malnourished patients. (Arch Surg 1987;122:610-614) References 1. Kirkpatrick JR: Nutrition and Metabolism in the Surgical Patient . Mt Kisco, NY, Futura Publishing Co, 1983, pp 485-486. 2. Payne JH, DeWind LT, Commons RR: Metabolic observations in patients with jejunocolic shunts . Am J Surg 1963;106:273-289.Crossref 3. Payne JH, DeWind LT: Surgical treatment of obesity . Am J Surg 1969;118:141-147.Crossref 4. Scott HW Jr, Law DH IV, Sandstead HH, et al: Jejunoileal shunt in surgical treatment of morbid obesity . Ann Surg 1970;171:770-782.Crossref 5. Bray GA, Barry RE, Benfield JR, et al: Intestinal bypass operation as a treatment for obesity . Ann Intern Med 1976;85:97-105.Crossref 6. Halverson JD, Gentry K, Wise L, et al: Reanastomosis after jejunoileal bypass . Surgery 1978;84:241-249. 7. Starkloff GG, Donovan JJ, Ramach KR, et al: Metabolic intestinal surgery, its complications and management . Arch Surg 1975;110:652-656.Crossref 8. Scott HW, Dean R, Shull JH, et al: New consideration in use of jejunoileal bypass in patients . Ann Surg 1973;177:723-735.Crossref 9. Buchwald H, Varco RL, Moore RB, et al: Intestinal bypass procedures . Curr Probl Surg , (May) 1975, pp 1-51. 10. Griffen WO Jr, Bivins BA, Bell RM: The decline and fall of the jejunoileal bypass . Surg Gynecol Obstet 1983;157:301-308. 11. Yates BT: Survey of 3146 patients receiving jejunoileal or gastric bypass . Am J Clin Nutr 1980;33:518-522. 12. Andersen T, Juhl E, Quaade F: Jejunoileal bypass: What can we learn from a literature study? Am J Clin Nutr 1980;33:440-445. 13. Hitchcock CT, Jewell WR, Hardin CA, et al: Management of the morbidly obese patient after small bowel bypass failure . Surgery 1977;82: 356-361. 14. Griffen WO Jr, Hostetter JM, Bell RM, et al: Experiences with conversion of jejunoileal bypass procedures for morbid obesity . Ann Surg 1977;186:500-509.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1987

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