Halverson J D, Wise L, Wazna M F, Ballinger W F
Am J Med. 1978 Mar;64(3):461-75. doi: 10.1016/0002-9343(78)90233-4.
One hundred one carefully screened morbidity obese patients underwent jejunoileal bypass and were followed closely over a mean follow-up period of 32 months. Although there were no operative deaths, three per cent of patients died postoperatively of liver failure or its complications. A fourth patient died of a pulmonary embolus after reoperation, and the fifth patient died cachectic with severe diarrhea after excessive weight loss. Nineteen per cent of the patients required restoration of intestinal continuity (reversal), most for either liver failure or late fluid and electrolyte derangements. All but two survived reversal and are doing well despite massive weight gain. Fifty-eight per cent of the patients had major complications which either required major reoperation (reversal, cholecystectomy or incisional hernia repair) or were potentially life-threatening (liver failure, hepatic fibrosis or urinary tract stones). As described in other series, abnormalities in serum electrolytes and vitamins were seen. In addition, hypovitaminosis D occurred in a number of patients and as with other serum parameters measured, was time-dependent in that improvement was seen in most patients over the postoperative interval studied. Because of the high rate of complications and reversals, we believe that jejunoileal bypass should be reserved for patients with morbid obesity whose lives are imminently threatened by obesity or its sequellae.
101例经过仔细筛选的病态肥胖患者接受了空肠回肠分流术，并在平均32个月的随访期内进行了密切随访。虽然没有手术死亡病例，但有3%的患者术后死于肝功能衰竭或其并发症。第四例患者在再次手术后死于肺栓塞，第五例患者在体重过度减轻后因恶病质和严重腹泻死亡。19%的患者需要恢复肠道连续性（逆转手术），大多数是因为肝功能衰竭或晚期液体和电解质紊乱。除两名患者外，所有接受逆转手术的患者均存活，尽管体重大幅增加，但情况良好。58%的患者出现了严重并发症，这些并发症要么需要进行大型再次手术（逆转手术、胆囊切除术或切口疝修补术），要么具有潜在生命危险（肝功能衰竭、肝纤维化或尿路结石）。正如其他系列报道中所描述的，血清电解质和维生素出现了异常。此外，许多患者发生了维生素D缺乏症，与所测量的其他血清参数一样，它与时间有关，即在研究的术后期间，大多数患者的情况有所改善。由于并发症和逆转手术的发生率很高，我们认为空肠回肠分流术应仅用于那些因肥胖或其后遗症而生命受到紧迫威胁的病态肥胖患者。
