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Long-term Outcome in a Series of Jejunoileal Bypass Patients.
MedLine Citation:
PMID:  10757927     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In 65 jejunolleal (JI) bypasses done from 1973-1979, there were nine Scott and 56 Payne (with Y-shaped anastomosis). Preoperative excess body weight (EBW) translated to the 1983 Metropolitan Tables was 112 +/- 30%. Eight patients are lost to follow-up. We reversed seven patients for renal stones (12%) accompanied by a vertical banded gastroplasty (VBG) and one because she demanded a VBG. Five patients were reversed by surgeons elsewhere for minor problems (three with an accompanying gastric reduction operation), and all five regained and requested a JI bypass again, which we now refused to undertake. This leaves 44 JI bypass patients being followed: loss of EBW is 71 +/- 22% at 12-18 years. The eight reversed by us accompanied by a VBG regained some weight (loss of EBW from initial weight is 56 +/- 18%). Liver biopsies were done for 5 years in 31 patients, and showed improvement by 36 months. Patients took predigested collagen capsules plus high protein and multivitamins. Injections of B12 are indicated in 18 patients, given every 3 months. Liver dysfunction has not occurred in the long-term. Low serum carotene levels persist. Migratory arthraigias were controlled by oral metronidazole and did not occur after the fifth year. Oxalate crystals remain on urinalysis. Potassium and magnesium replacement is not required now, and a mean of 2.5 stools per day is not a problem, with infrequent diarrhea after greasy foods. Metronidazole is continued in 33 patients to prevent foul flatus. One patient developed a brain tumor, one myxedema, and one primary hyperparathyroidism, thought to be complications of the bypass until diagnosed. Most patients appear to be doing well.
Authors:
Deitel; Shahi; Anand; Deitel; Cardinell
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Obesity surgery     Volume:  3     ISSN:  -     ISO Abbreviation:  Obes Surg     Publication Date:  1993 Aug 
Date Detail:
Created Date:  2000-04-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  247-252     Citation Subset:  -    
Affiliation:
Departments of Surgery and Nutritional Sciences, University of Toronto, St. Joseph's Health Centre, Toronto, M6R 1B5, Canada.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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