Polymorphonuclear (PMN) Function after Small Intestinal Shunt Operation for Morbid Obesity

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Abstract
The possible influence on blood polymorphonuclear (PMN) granulocyte functions of the small intestinal shunt operation for obesity was studied in 10 massively overweight patients. They were investigated prior to operation and for 9 mo. afterwards, when they had lost on average 32 kg body wt. Pre-operatively they showed reduced PMN bactericidal capacity and increased PMN adherence compared with controls of normal weight. During the first 2-4 mo. postoperatively all patients displayed a gradually increasing bactericidal capacity, which then reached levels similar to the controls and remained so for the rest of the follow-up period. This enhancement was more easily assessed by a new in vitro assay in which each PMN was provided with 30-40 bacteria, than by a standard assay using 2-4 bacteria/granulocyte. PMN adherence decreased during the 1st postoperative months and then returned to preoperative levels. The changes in PMN functions were not statistically related to each other or to the continuous loss of body weight. Thus, impairment of PMN killing function occurring in extremely obese patients became normalized after small bowel shunt operation, while the high adherence remained unchanged.