August 1981

Conversion of Jejunoileal Bypass to Gastric Bypass

Arch Surg. 1981;116(8):1099. doi:10.1001/archsurg.1981.01380200095022

To the Editor.–I would like to echo Dr Wright's editorial comments regarding the article by Griffen et al, "Experiences With Conversion of Jejunoileal Bypass to Gastric Bypass" (Archives 1981;116:320-324). Dr Griffen and his associates appropriately warn that patients undergoing takedown of jejunoileal bypass (JIB) will almost invariably regain weight to their prebypass morbid state. They advocate gastric bypass at the same time as JIB takedown except in patients with severe hepatic complications. We certainly agree with this concept but share Dr Wright's concern about employing gastric bypass, which necessitates an additional major anastomosis. The high gastrojejunostomy is a difficult anastomosis. Furthermore, in the patient having a JIB, this entails suturing jejunum that is atrophic because it has been excluded from the intestinal tract for some time. This fact may account for the two gastrojejunostomy leaks (7%) reported in this series.

At Denver General Hospital, we prefer to employ gastric

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