Obesity, Small-Bowel Bypass and Liver Disease

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Abstract
Total starvation or marked caloric restriction can achieve temporary weight loss in massively obese persons, but long-term reduction in weight has proved much more difficult. Frustrated by the failure of medical forms of therapy, some physicians have tried rather drastic surgical procedures that create a short-bowel syndrome and lead to weight reduction by loss of fat and protein in stool. The first procedure investigated extensively was the jejunocolic shunt,1 in which 38 to 76 cm of jejunum beyond the ligament of Treitz was anastomosed to the mid-transverse colon, and the remaining small bowel left as a blind loop. Ten years . . .

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