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August 1971

Morphologic Changes of the Liver Following Small Intestinal Bypass for Obesity

Author Affiliations

From the departments of surgery and pathology, Royal Victoria Hospital and McGill University, Montreal. Dr. Mackenzie is now with the Department of Surgery, McMaster University, Hamilton, Ontario.

Arch Surg. 1971;103(2):229-237. doi:10.1001/archsurg.1971.01350080145022

Ten patients were studied one to seven years following small intestinal bypass for obesity. Liver function tests, normal preoperatively and abnormal early postoperatively, returned to normal 6 to 12 months later. Total serum cholesterol levels decreased by 40% to 50%. Serum protein values stayed within normal limits if the patient was on a high protein diet. Liver biopsies for fatty change preoperatively showed variations from 1% to 75% infiltration. Late postoperative observations in nine patients showed an increase in fatty infiltration in six. In two there was a decrease and in one there was no change. Of these nine patients, in two who developed 80% to 90% infiltration postoperatively, restoration of continuity abolished this histologic evidence of fatty metamorphosis. No evidence of cirrhosis was observed in any patient.