Starkloff G B, Donovan J F, Ramach K R, Wolfe B M
Arch Surg. 1975 May;110(5):652-7. doi: 10.1001/archsurg.1975.01360110198034.
From November 1970 to August 1974 small intestinal bypass was performed in 475 patients for morbid obesity with an operative mortality of 1.6%. Immediate postoperative complications were superficial wound infection (17 patients), pulmonary complications (seven patients), cardiac complications (five patients), wound dehiscence (nine patients), intestinal tract fistula (four patients), and miscellaneous complications (14 patients). Delayed complications included hypokalemia (28%), hypocalcemia (9%), anemia (11%), calcium oxalate urinary calculi (6%), gout (2%), and hepatic failure (1.4%). Fourteen patients died of late complications. Ventral incisional hernia occurred in 3% of the patients; failure to lose sufficient weight in 21%, all but one occurring in patients with end-to-side shunts. Thirteen end-to-side shunts have been converted to end-to-end shunts because of insufficient weight loss. A team concept is important in the handling of the morbidly obese. Small bowel bypass is effective in producing sustained weight reduction in these patients. Careful and continued study of these patients for the rest of their lives is of paramount importance.
1970年11月至1974年8月，对475例病态肥胖患者实施了小肠旁路手术，手术死亡率为1.6%。术后即刻并发症包括表浅伤口感染（17例）、肺部并发症（7例）、心脏并发症（5例）、伤口裂开（9例）、肠道瘘（4例）及其他并发症（14例）。延迟性并发症包括低钾血症（28%）、低钙血症（9%）、贫血（11%）、草酸钙尿路结石（6%）、痛风（2%）及肝功能衰竭（1.4%）。14例患者死于晚期并发症。3%的患者发生腹直肌切口疝；21%的患者体重减轻不足，除1例患者外，均发生在端侧分流患者中。13例端侧分流因体重减轻不足已改为端端分流。团队理念在处理病态肥胖患者时很重要。小肠旁路手术对这些患者持续减轻体重有效。对这些患者进行终生仔细且持续的研究至关重要。
