MANAGEMENT OF MORBIDLY OBESE PATIENT AFTER SMALL BOWEL BYPASS FAILURE

  • 1 January 1977
    • journal article
    • research article
    • Vol. 82  (3) , 356-361
Abstract
Patients (14) underwent small bowel bypass (SBB) takedown for complications such as chronic nausea and vomiting, excessive flatus, intractable diarrhea, liver dysfunction, electrolyte imbalance, hyperoxaluria with renal stones and arthritis. The average weight loss in these 14 patients after SBB was 93 lb (34% of initial weight), with a mean follow-up of 23 mo. Of the 14 patients, 4 had SSB takedown only and gained an average of 36 lb over the ensuing 14 mo. Similarly, 3 patients had SBB takedown with delayed (asynchronous) gastric bypass (GB) and gained an average of 55 lb during the 14 mo. prior to GB. Following GB these 3 patients lost only an additional 8 lb over a 12 mo. period, leaving them 47 lb heavier than at the time of SBB takedown. Patients (7) treated with SBB takedown and synchronous GB maintained the weight reduction obtained with SBB and had further modest weight reductions (average, 18 lb), for a mean follow-up of 8 mo. There were no serious operative or late complications with any of the above operations. The complications leading to SBB takedown were resolved in each case. Synchronous GB is an effective means of maintaining the weight reduction in the morbidly obese patient after SBB takedown.

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