Biliary-intestinal bypass in the treatment of obesity: long term follow up.

OBJECTIVE

To evaluate the long term outcome after biliary-intestinal bypass for morbid obesity.

METHODS

Retrospective study.

METHODS

County hospital, Sweden.

METHODS

120 consecutive patients operated on between 1977 and 1990.

METHODS

A variation of jejunoileal bypass in which the excluded bowel was anastomosed to the gallbladder.

METHODS

Weight, concentrations of blood lipids and glucose in blood, results of liver function tests, reversal rates, and complications.

RESULTS

The mean body mass index was reduced by 39% (from 42 kg/m2 to 26 kg/m2), serum cholesterol and triglyceride concentrations by more than 30%, and fasting blood glucose concentrations by 1 1%. There were no cases of irreversible hepatic failure, diabetes, deaths related to the operation, or progressive renal failure. The incidence of renal calculi increased by a ratio 2.3. The reversal rate/year was 2% (n = 20).

CONCLUSIONS

We conclude that biliary-intestinal bypass may be used to treat cases of obesity associated with seriously high blood lipid concentrations and where gastric restrictive operations are less suitable.