A REVIEW OF 20 YEARS OF JEJUNOILEAL BYPASS

Background: The long-term effects of jejunoileostomy for morbid obesit y were studied 15-20 years after surgery, in 60 patients. Methods: A t otal of 141 patients underwent surgery during the years 1973 to 1979. Thirty-four (24%) had had bowel continuity reestablished because of si de effects. Eight (5.6%) were dead, 4 (2.8%) had emigrated, and 11 (7. 8%) lived in remote areas, leaving 84 patients for follow-up. Sixty of these patients agreed to participate in the study. Seventy-seven per cent of the study population were women, with a mean age of 50 years. Results: The average weight loss was 50.2 kg; only one patient had reg ained the preoperative weight. The average weight was 84.2 kg. Reporte d side effects were 1) gastrointestinal: diarrhoea (61.7%), bad defeca tion smells (60%), and meteorism (11.7%), and 2) systemic: arthralgia (18.3%) and symptomatic nephro/cholelithiasis (18.3%). Forty-two patie nts (70% of the participants) found the results acceptable/satisfactor y. Nine patients (15%) had vitamin B-12 injections regularly; another 22 (35%) were found to have a low cobalamin level, and 35 patients (58 %) had reduced P-magnesium. The 25-hydroxycholecalciferol level was lo w in 26 patients (43%), and parathyroid hormone values were increased in 18 (30%). Fifty seven patients (95%) had a P-carotene value lower t han the normal limit. Conclusion: These results stress the need for co ntinuous control and supplementary therapy.