Change of Bile Acid Metabolism and Absorption of Vitamin B12 after Intestinal Shunt Operation in Obesity

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Abstract
Danö, P. & Lenz, K. Change of bile acid metabolism and absorption of vitamin B12 after intestinal shunt operation in obesity. A comparison of three types of operation. Scand. J. Gastroent. 1974, 9, 159-165. An intestinal shunt operation for obesity was made in 33 patients. Three types of operation were compared. Type I: 36 cm of proximal jejunum anastomosed end-to-side to 12 cm terminal ileum. Type II: 24 cm jejunum + 24 cm ileum. Type III: 12 cm jejunum + 36 cm ileum. After the operation we found a statistically significant increase of the glycine/taurine ratio in jejunal contents and of the transfer of glycine conjugates to the colon (abnormal ‘breath test’). There was a significant decrease of the bile acid concentration in the jejunum and of the absorption of vitamin B12. As regards the abnormal breath test and diminished vitamin B12 absorption, the results in type III-operated patients deviated significantly less from normal values than the results in patients with type I or II-operations. The study favours the choice of a type III-operation which preserves the longest segment of terminal ileum.