The role of surgery in the malabsorption syndrome is directed toward the removal of any contributing gastrointestinal pathology. Intrinsic and extrinsic obstructive lesions are eliminated; intestinal fistulae and short-circuiting operations are frequently taken down to permit the use of the absorptive surface of the entire bowel. Experimental surgical attempts to control excessive caloric loss through hypermotility include vagotomy1,2,4,5 and use of a reversed segment of the intestine.8,9 After an extensive small bowel resection, the remaining absorptive mucosa is put to task to maintain nutrition. There is inadequate absorption of foodstuffs, vitamins, and minerals. The possibility of reutilizing the remaining absorptive mucosa by means of recirculation of the intestinal chyme appears to be worthy of study.
Ten dogs were studied. Each was anesthetized with pentobarbital, 27 mg. per kilogram. Initially, recirculation loops were established in two animals (Fig. 1, a). A jejunal circuit was made end-to-side in one