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Abstract
Fourteen patients underwent small bowel bypass (SBB) takedown for complications such
as chronic nausea and vomiting, excessive flatus, intractable diarrhea, liver dysfunction,
electrolyte imbalance, hyperoxaluria with renal stones, and arthritis. The average
weight loss in these 14 patients after SBB was 93 pounds (34% of initial weight),
with a mean follow-up of 23 months. Four of the 14 patients had SBB takedown only
and gained an average of 36 pounds over the ensuing 14 months. Similarly, three patients
had SBB takedown with delayed (asynchronous) gastric bypass (GB) and gained an average
of 55 pounds during the 14 months prior to GB. Following GB these three patients lost
only an additional 8 pounds over a 12 month period, leaving them 47 pounds heavier
than at the time of SBB takedown. In contrast, seven patients treated with SBB takedown
and synchronous GB not only maintained the weight reduction obtained with SBB, but,
in addition, had further modest weight reductions (average, 18 pounds), for a mean
follow-up of 8 months. There were no serious operative or late complications with
any of the above operations. In addition, the complications leading to SBB takedown
resolved in each case. It is concluded that synchronous GB is an effective means of
maintaining the weight reduction in the morbidly obese patient after SBB takedown.
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Article info
Footnotes
☆Presented at the Thirty-fourth Annual Meeting of the Central Surgical Association, Buffalo, N. Y., March 3–5 1977.
Identification
Copyright
© 1977 Published by Elsevier Inc.
