Revision of intestinal bypass procedures.
The results of jejunoileal bypass have been satisfactory in 80 per cent of the patients. In the remaining 20 per cent, one or more problems eventually may require revision of the bypass. These problems fall into four categories: inadequate weight loss; excessive weight loss; persistent uncontrollable diarrhea or associated severe anorectal problems, or both, and severe unmanageable electrolyte and metabolic imbalance with or without liver failure. In our series, 108 patients were observed for one to five years, and ten patients required revision, one revision for every 12 bypass operations performed. The preoperative evaluation and management and the options available to the surgeon in correcting the abnormalities are evaluated. The results of ten patients who underwent revision of the bypass and the rationale for the revision are outlined. Criteria for an ideal operation have not as yet been attained.
D000293:Adolescent; D000328:Adult; D003106:Colon / Q000601:surgery; D003967:Diarrhea / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D011183:Postoperative Complications / Q000601:surgery; D011300:Preoperative Care; D014883:Water-Electrolyte Imbalance / Q000601:surgery