Complications of Small Intestinal Short-Circuiting for Obesity

SINCE 1956, controlled surgical intestinal bypass has been performed for obesity in a number of patients with careful preoperative evaluation and a detailed follow-up examination over a period of several years.^1-3 Prior to this, there were only the sporadic cases reported within the literature where massive small intestinal resection in man was performed because of either vascular occlusion or extensive tumor which involved the small intestine and its blood supply. There are well-documented human cases which reveal that the loss of 80% to 90% of the small intestine has been compatible with survival for several years.^4-6

The effects of resectional surgery and the associated nutritional abnormalities are well known. However, the recent bypass operations have been followed for only a few years, and the literature of the complications has been meager. The consequences of these operations appear to be of an unpredictable nature; this is possibly due to