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December 1976

Reversibility of Hepatic Failure Following Jejunoileal Bypass

Author Affiliations

From the Department of Surgery, Kern Medical Center, Bakersfield, Calif (Drs Geiss and Watts), and the Delano (Calif) Community Hospital (Dr Shields).

Arch Surg. 1976;111(12):1362-1365. doi:10.1001/archsurg.1976.01360300052008

• Jejunoileal bypass was performed in 50 morbidly obese patients. The morbidity encountered compared favorably with that of other series. All patients manifesting hepatic failure demonstrated hyperbilirubinemia within the first three months postoperatively. Hyperbilirubinemia, if uncorrected, resulted in a mortality of 75%. Augmentation jejunal interposition was performed in three patients who demonstrated hepatic decompensation or severe electrolyte imbalance or both. This resulted in rapid correction of electrolyte disturbances, liver function measurements, and patient symptoms without significant postoperative weight gain. Persistent hyperbilirubinemia or recalcitrant electrolyte problems or both are indications for augmentation jejunal interposition.

(Arch Surg 111:1362-1365, 1976)

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