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Jejunoileal Bypass In The Treatment Of Morbid Obesity
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Jejunoileal Bypass In The Treatment Of Morbid Obesity: A 25-Year Follow-Up Study Of 36 Patients
Induction of intestinal malabsorption by jejunoileal bypass was a widely performed procedure for morbid obesity in the 1970's. The purpose of this study was to evaluate the long-term results.
A total of 36 patients underwent jejunoileal bypass from November 1971 to September 1976. At operation the median age was 33 years and median BMI 42 kg/m2. Shunt lengths varied between 45 and 60 cm. The present check-up of the 28 patients still alive included clinical examination, biochemical tests, bone density measurement and measurement of fecal fat excretion.
10 patients (28%) had had their shunt reversed. With one exception these patients quickly regained weight, and 5 (50%) of them were dead. 23 patients with an intact jejunoileal bypass shunt are alive, but 5 of them have had the shunt shortened due to weight gain. Their median age today is 56 years, and median BMI is 30. None of these patients were known to have coronary heart disease or diabetes mellitus at follow-up. Malabsorption of fat is still present. Blind loop syndrome, flatulence, foul fecal smell and diarrhea are the most troublesome long-term sequelae of jejunoileal bypass. Vitamin and mineral deficiencies are common. 2 of 21 patients (age 80 and 57 years) have osteoporosis.
When the optimal shunt length for the individual patient is found, jejunoileal bypass maintains a substantially reduced weight for 25 years. Vitamin and mineral deficiencies are common, but no serious clinical deficiency states are seen.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources