Biliary-intestinal bypass in the treatment of obesity: long term follow up.

OBJECTIVE: To evaluate the long term outcome after biliary-intestinal bypass for morbid obesity. DESIGN: Retrospective study. SETTING: County hospital, Sweden. SUBJECTS: 120 consecutive patients operated on between 1977 and 1990. INTERVENTIONS: A variation of jejunoileal bypass in which the excluded bowel was anastomosed to the gallbladder. MAIN OUTCOME MEASURES: Weight, concentrations of blood lipids and glucose in blood, results of liver function tests, reversal rates, and complications. RESULTS: The mean body mass index was reduced by 39% (from 42 kg/m2 to 26 kg/m2), serum cholesterol and triglyceride concentrations by more than 30%, and fasting blood glucose concentrations by 1 1%. There were no cases of irreversible hepatic failure, diabetes, deaths related to the operation, or progressive renal failure. The incidence of renal calculi increased by a ratio 2.3. The reversal rate/year was 2% (n = 20). CONCLUSION: We conclude that biliary-intestinal bypass may be used to treat cases of obesity associated with seriously high blood lipid concentrations and where gastric restrictive operations are less suitable.