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Interval Jejunoileal Bypass Reduces Morbidity Mortality of Roux-en-Y Bypass in Super-Obese

Review of Jejunoileal Bypass Surgical Procedure to Reduce Health Risks in Patients with Super-Obesity

Bariatric Surgery - Bariatric Research Studies

Interval Jejunoileal Bypass Reduces the Morbidity and Mortality of Roux-en-Y Gastric Bypass in the Super-Obese

Among Roux-en-Y gastric bypass (RYGB) patients, large male patients carry the greatest risk for severe, life-threatening complications. The higher complication rate is partly related to large amounts of intra-abdominal fat that increases the technical difficulty of the Roux-en-Y gastric bypass.

Method

In order to minimize the risk for complications, we established a staged approach for weight loss surgery for high-risk, super-obese patients. Patients with intra-abdominal fat at exploration which precluded the performance of Roux-en-Y gastric bypass underwent jejunoileal bypass (JIB). Following an initial period of weight loss (6-24 months), they were converted to a Roux-en-Y gastric bypass during a second operation. Twenty-four patients underwent initial JIB that was associated with a major complication rate of 8.3 per cent (2/24) and no mortality.

Results

Eight patients lost 53.4 +/- 6.3 kg prior to their conversion to Roux-en-Y gastric bypass (mean, 14.1 months). There was one major complication (12%) and no deaths (0%). Following RYGB, an additional period of weight loss resulted in overall excess weight loss (EWL) totaling 62 per cent.

Conclusion

A two-step procedure is a safe and effective approach for minimizing complications for high-risk patients undergoing Roux-en-Y gastric bypass. The initial JIB was associated with low morbidity and no mortality, and the follow-up RYGB procedure was a technically simple operation that could be performed with few complications.

Source:
Arteaga JR, Huerta S, Basa NR, Livingston EH. VA Greater LA Healthcare System, Los Angeles, California, USA.
National Library of Medicine 2003

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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