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April 1973

Surgical Treatment of Morbid ObesitySixteen Years of Experience

Author Affiliations

Los Angeles
From the departments of surgery (Drs. Payne and Schwab), medicine (Dr. DeWind), and pathology (Dr. Kern), University of Southern California School of Medicine, and the Hospital of the Good Samaritan Medical Center, Los Angeles.

Arch Surg. 1973;106(4):432-437. doi:10.1001/archsurg.1973.01350160050008

Over a 16-year period, 165 intestinal shunts (12 jejunocolic and 153 jejunoileo) were performed. The last 140 patients received an end-to-side shunt using 14 inches (35.6 cm) of jejunum and 4 inches (10.2 cm) of ileum. The short- and long-term weight losses have been satisfactory. Only four jejunoileo shunts have required restoration of continuity. Sixteen of the 165 have required revision of the bypass. Sequential liver biopsies tend to reveal an increase in fat in the early postoperative stages and an improvement later. The overall mortality related to the intestinal bypass was 6%. In view of the fact that criteria for selection of patients for intestinal shunt have remained rigid, we consider this mortality to be acceptably low.