[The biliointestinal bypass: a thirty-years experience].
OBJECTIVE
Aim of our study was the evaluation of Italian experience with bilio-intestinal bypass in the surgical treatment of morbid obesity.


METHODS
1030 patients; mean age 36.1 years; preoperative mean weight Kg 136.7; mean preoperative BMI 48.9 kg/m2; mean follow-up 68 years (1-28). 838 patients underwent open and 192 laparoscopic bilio-intestinal bypass. The laparoscopy operation was performed with five lap ports. Section of the jejunum 30 cm from the Treitz was made by linear stapler. The cholecysto-jejunal anastomosis was completed with 45 mm linear stapler. A side-to-side anastomosis between the proximal jejunum and the last 12-18 cm of the ileum was created by firing a 60 mm linear stapler.


RESULTS
Weight loss was satisfactory in 93% of operated patients. Comorbidities (arterial hypertension, diabetes, sleep apnea syndrome) solved in majority of the patients. The main late complications were incisional hernia in open technique and oxalic nephrolithiasis. The reversal rate was 2.5%.


CONCLUSIONS
Our experience showed that bilio-intestinal bypass can obtain good results. Using laparoscopic technique it is possible to reduce pain, in-hospital time, respiratory and thromboembolic complications, convalescence and incisional hernia.
Dipartimento di Scienze Chirurgiche - Cattedra di Chirurgia Generale dell' Università degli Studi di Milano, UOC di Chirurgia Generale, Istituto Clinico "Sant'Ambrogio", Milano. giancarlo.micheletto@unimi.it
Giancarlo
G
Micheletto
Marco
M
Badiali
Pier Giorgio
PG
Danelli
Roberto
R
Sacco
Barbara
B
Sala
Santo Bressani
SB
Doldi
D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007558:Italy; D007581:Jejunoileal Bypass / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss