Surgical approach to the short-bowel syndrome: procedures to slow intestinal transit.

Procedures designed to slow intestinal transit should be applied cautiously in patients with near adequate remnant length and demonstrated rapid transit. They should be considered after maximum adaptation has occurred. A reversed intestinal segment appears to be efficacious in the short term. Colon interposition and intestinal valves might also have merit in selected patients but clinical experience is limited. Unfortunately, these procedures are applicable to only a small proportion of patients with SBS.