Role of the surgeon in managing hypercholesterolemia

Abstract

In 1962 the partial ileal bypass (PIB) was introduced as the first operation specifically designed to treat hypercholesterolemia. 1 Buchwald H. Surgical operation to lower circulating cholesterol. Circulation. 1963; 28: II649 Google Scholar Ten years later the Program on the Surgical Control of the Hyperlipidemias (POSCH) was launched, with PIB used as the intervention modality. POSCH (1972 to 1997) has been the only surgical randomized clinical trial to test the efficacy of cholesterol lowering in the management of atherosclerosis and its clinical manifestations. 2 Buchwald H Varco RL Matts JP Long JM Fitch LL Campbell GS et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. N Engl J Med. 1990; 323: 946-955 Crossref PubMed Scopus (853) Google Scholar , 3 Buchwald H Matts JP Fitch LL Campos CT Sanmarco ME Amplatz K et al. Changes in sequential coronary arteriograms and subsequent coronary events. JAMA. 1992; 268: 1429-1433 Crossref PubMed Scopus (163) Google Scholar , 4 Buchwald H Campos CT Varco RL Boen JR Williams SE Hansen BJ et al. Effective lipid modification by partial ileal bypass reduced long-term coronary heart disease mortality and morbidity: five-year posttrial follow-up report from the POSCH. Arch Intern Med. 1998; 158: 1253-1261 Crossref PubMed Scopus (115) Google Scholar PIB and POSCH are the subjects of this short review of the role of the surgeon in managing hypercholesterolemia.