Long-term follow-up of jejunoileal bypass patients

A follow up of 101 patients for a period of 50 months postoperatively after jejunoileal bypass was carried out. All but 3 had end-to-end anastomosis with bypass of about 90% of small bowel. There were no operation deaths, but 5 patients died late postoperatively; 2 after reanastomosis. 23 patients (25%) required reanastomosis; hepatic dysfunction 5%, electrolyte depletion 5% and malnutrition 6% were the main complications demanding reanastomosis. Of the 70 patients living with the bypass, 7% complained of exhaustion and 26% of extreme fatigue associated with electrolyte deficit, diarrhea or both. Of the total, 21% had no problems, 34% minor problems, 39% major problems (urolithiasis, cholelithiasis, uncontrollable vitamin deficiencies) and 6% severe problems requiring hospitalization. About one third of the patients have not reached acceptable weight levels 4 years after the bypass. Given the mortality rate and high rate of reanastomosis, together with a large proportion suffering from significant problems the use of jejunoileal bypass appears to be unjustified, particularly in view of the frequent inadequate weight loss.