Jejunoileal Bypass Long-term Results

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Abstract
Between Oct. 1967 and Nov. 1977, the jejunoileal bypass was performed on 177 patients for morbid exogenous obesity. The female-male ratio was 9:1. The mean follow-up period was 3.4 yr and their ages ranged from 15 to 58 yr. Of this patient population base, 85% were between the ages of 21 and 49 yr and in 83% the onset of obesity was in childhood. Four parameters were used to assess the effectiveness of this procedure: the ponderal index; the percent of ideal weight; complications and diarrhea. Using the ponderal index, 38% of the results were excellent, 20% satisfactory and 25% poor. When the percent of ideal weight was used, the results were 24, 27 and 32%, respectively. For complications, the results were 55, 23 and 5% and with diarrhea, 53, 22 and 8%. A summary of these mean values was 42.5, 23 and 17.5% for excellent, satisfactory and poor results. There were 4 deaths in this series, occurring 2-16 mo. postoperatively, due to sepsis, pulmonary embolism, drug overdose and liver failure. Of the 28 patients (17%) requiring revision, 8 were revised for inadequate weight loss, 4 for excessive weight loss, 15 for uncontrollable diarrhea and 11 for metabolic electrolyte problems. In 14% the revision was required for multiple indications. A review of 100 of these patients to determine their response to the procedure revealed tht 91% were able to recommend the procedure to other patients and interpreted their results as being excellent in 51%, good in 36% and fair in 11%. Continued use of this procedure should be deferred pending much needed investigation of the associated complications.