Reversal of jejunoileal bypass in patients with morbid obesity.

ABSTRACT

Jejunoileal bypass for morbid obesity was performed on 182 patients between 1971 and 1982. At 19 years' follow-up 60 (33 per cent) have had to undergo reversal. The compelling reasons for reversal were life-threatening malnutrition, immune complex disease, renal oxalate stones, osteomalacia and severe electrolyte disturbance. All patients gained weight after reversal of the jejunoileal bypass; most gained all the weight they had lost. Thirty-one patients returned to grade III obesity and 14 to grade II. Twelve patients had an associated vertical gastroplasty ten regained their previous weight and only two stayed within normal weight. Patients were generally free from bypass-associated symptoms and complications apart from arthralgia and arthritis. This report concludes a series of articles published by the authors on jejunoileal bypass over the past 20 years describing the rise and fall of this surgical procedure.