A prospective comparison of the jejunoileal and gastric bypass operations for morbid obesity.

Abstract

AbstractA prospective, randomized clinical trial has been conducted in 38 morbidly obese patients to compare jejunoileal bypass (19 patients) with gastric bypass (19 patients). At this point the patients have been followed up for periods of from 1 month to 2 years, and 12 patients in each surgical group have been observed for 6 months or longer after operation. There was one death among the 38 patients, a woman with a gastric bypass who developed a pulmonary embolus 22 days postoperatively. Gastric bypass resulted in somewhat greater weight loss than jejunoileal bypass. Although the follow‐up period has been short, jejunoileal bypass has resulted in greater morbidity and expense to the patient than gastric bypass. In particular, gastric bypass did not cause progression of liver lesions in any of the 6 patients who had liver biopsies 1 year postoperatively, while jejunoileal bypass was associated with development of fatty metamorphosis in the liver of 3 patients after 1 year. The entry of new patients into the clinical trial has been discontinued because we believe there is sufficient evidence to indicate that gastric bypass is superior to jejunoileal bypass in the treatment of morbid obesity.