The influence of jejunoileal ratio on plasma electrolytes and liver function in intestinal bypass for morbid obesity. A randomized trial.

In a randomized clinical trial 89 obese patients had end-to-side jejunoileostomy with either a 1:3 or a 3:1 ratio between jejunum and ileum left in continuity. The duration of postoperative observation was at least 36 months. Repeated assessments were made on plasma concentrations of sodium, potassium, bicarbonate, magnesium, calcium, aspartate aminotransferase, and clotting factors. The major findings were that bypass surgery (i) has no important influence on levels of sodium, bicarbonate, and calcium, (ii) induces potassium depletion and transient liver dysfunction of a degree that is independent of the jejunoileal ratio, and (iii) induces a greater magnesium depletion when a long jejunum and short ileum segment are left in continuity.