Modified Jejunoileal Bypass Surgery with Biliary Diversion for Morbid Obesity and Changes in Liver Histology During Follow-up

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2007 May 22

PMID 17514410

Citations 6

Authors

Iraj Fazel

Akram Pourshams

Shahin Merat

Roya Hemayati

Masoud Sotoudeh

Reza Malekzadeh

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Bariatric surgery is the most effective treatment for morbid obesity. The classic procedure, jejunoileal bypass, has many complications including rapid progress of liver disease. The senior author (I.F.) has developed a modification of jejunoileal bypass, which we believe overcomes many of the shortcomings of the classic procedure.

Methods: Consecutive patients referring for bariatric surgery were included. A modified jejunoileal bypass in which the defunctionalized limb is eliminated by anastomosing its ends to the gall bladder and cecum was performed. Liver biopsies were taken during operation and at a mean of 16 months later. The patients were followed for 5 years.

Results: Forty-three patients were enrolled. The mean value of weight and body mass index (BMI) fell from 128 kg and 46 kg/m(2) before operation to 85 kg and 31 kg/m(2) at 5 years, respectively (p < 0.001). There was no significant change in the degree of liver steatosis and necroinflammation. The mean liver fibrosis score increased from 0.1 to 0.9 (p = 0.015). No sign of advanced liver disease was observed during the 5-year follow-up.

Conclusion: The modified jejunoileal bypass is very effective in inducing and maintaining weight loss for 5 years and does not lead to hepatic failure or rapid progression of liver disease.

Citing Articles

Bariatric intervention improves metabolic dysfunction-associated steatohepatitis in patients with obesity: A systematic review and meta-analysis.

Hwang J, Hwang H, Shin H, Kim B, Kang S, Yoo J Clin Mol Hepatol. 2024; 30(3):561-576.

PMID: 38830642 PMC: 11261233. DOI: 10.3350/cmh.2023.0384.

Small-bowel obstruction after modified jejunoileal bypass surgery due to gallstone ileus.

Kermansaravi M, Rokhgireh S, Jazi A, Pazouki A J Res Med Sci. 2019; 24:54.

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Outcomes of Reoperation After Laparoscopic Gastric Plication Failure.

Heidari R, Talebpour M, Soleyman-Jahi S, Zeinoddini A, Moghaddam A, Talebpour A Obes Surg. 2018; 29(2):376-386.

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Safety and efficacy of a side-to-side duodeno-ileal anastomosis for weight loss and type-2 diabetes: duodenal bipartition, a novel metabolic surgery procedure.

Gagner M Ann Surg Innov Res. 2015; 9:6.

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Gallstone ileus after biliointestinal bypass: report of two cases.

Micheletto G, Danelli P, Morandi A, Panizzo V, Montorsi M J Gastrointest Surg. 2013; 17(12):2162-5.

PMID: 23897084 DOI: 10.1007/s11605-013-2290-6.

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