Cardiovascular risk factors in obese patients treated with jejunoileal bypass operation: a 25-year follow-up study.
OBJECTIVE
Jejunoileal (JI) bypass was a widely performed surgical procedure for morbid obesity in the 1970s. The purpose of this study was to assess cardiovascular risk factors and mortality in patients 25 years or more after this operation.


METHODS
All (n = 36) patients operated on for obesity with JI bypass at Haukeland University Hospital between 1971 and 1976 were evaluated. Survivors (n = 28) participated in a follow-up that included clinical examination and biochemical tests. Preoperative data were compared with data at 1 year (3 years) and 25 years. Causes of death were identified for the deceased.


RESULTS
For the 23 patients alive with intact JI shunts at 25 years there was a statistically significant lowering of body mass index (BMI) (p < 0.01), systolic blood pressure (p < 0.05), diastolic blood pressure (p < 0.001) and serum cholesterol (p < 0.05) compared to before the operation. There was no statistically significant change in fasting blood glucose or serum triglyceride. The serum insulin level was normal in all but one (21/22) of the patients examined. Three out of 26 patients with intact JI shunts, and 5 out of 10 patients with reversed JI shunts, had died.


CONCLUSIONS
For patients with intact shunts there is a persistent reduction in body weight, serum cholesterol and blood pressure, and a reduced insulin resistance 25 years after JI bypass.
Våge
Villy
V
Department of Surgery, Ferde Central Hospital, Ferde, Norway. villy.vage@helse-forde.no
Berstad
Arnold
A
Solhaug
Jan Helge
JH
Viste
Asgaut
A
D000328:Adult; D017677:Age Distribution; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007581:Jejunoileal Bypass / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D013997:Time Factors