Lowering of Cholesterol Absorption and Blood Levels by Ileal Exclusion

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Abstract
Three separate experi-ments, involving rabbits, pigs, and human subjects, independently show marked, statistically significant, and permanent lowering of cholesterol levels following distal ileal exclusion. In human subjects, ileal exclusion at a sufficiently high level may eliminate all effective cholesterol reabsorption in the enterohepatic cholesterol circuit. Plasma cholesterol levels in the human subjects were depressed to well below the accepted normal values in the United States. The surgical procedure of ileal bypass may provide a therapeutic technique, not previously recognized, to lower circulating cholesterol levels substantially and enduringly in patients with hypercholesteremia. Such a clinical program was initiated at the University of Minnesota in May, 1963. Preliminary postoperative evaluation of the first 4 patients in our operative series shows a 50% reduction in cholesterol absorption as determined by radioactive tracer analysis, and a 30-60% decrease in the serum cholesterol values.