Jejunoileal bypass as a treatment of morbid obesity
J. M. Campbell, T. K. Hunt, J. H. Karam and P. H. Forsham
Seventy-five morbidly obese patients underwent jejunoileal bypass between
December 1968 and October 1975. The average weight of 45 patients who had
had the bypasses for over two years stabilized at 62.4% of the maximum
preoperative value. Postoperative complications included recurrent diarrhea
in 11% (8/74) and serum electrolyte deficits in 64% (48/75), most of which
were transient. Potassium and calcium deficiencies were usually correctable
by oral supplementation, but hypomagnesemia persisted in 23% (16/71)
despite supplementation. Nine percent (4/43) had biopsy-proved hepatic
cirrhosis after one year. Other complications were polyarthralgia, bone
demineralization, renal stones, and vasculitis. Three patients required
reanastomosis to original bowel continuity; all rapidly regained weight.
One died of vasculitis and hepatic failure attributable to the bypass.
Jejunoileal bypass is suitable only in morbidly obese patients with
particularly high motivation, whose risk factors outweigh those risks
incurred through bypass.
