THE metabolic effects of malabsorption due to loss of extensive lengths of small bowel in humans has been studied haphazardly. The small bowel was usually removed as an emergency measure, and metabolic comparisons to the preoperative state could not be made. Experimentally, Kremin et al1 in 1954, showed in dogs that resections of controlled lengths of small bowel resulted in impaired fat absorption and loss of weight.
Payne et al2 and Lewis et al3 produced weight loss in obese patients by means of controlled jejunocolic bypass. This procedure made it possible for them to study the metabolic changes that may result from exclusions of large segments of small bowel from the digestive tract.
Since March 1963, 11 obese patients have undergone controlled jejunocolic bypass at the Royal Victoria Hospital, Montreal. Our observations on the metabolic effects of this operation are presented.
Material and Methods
Selection of Patients.