Treatment of gross obesity by jejunal bypass.

Jejunal bypass operations were performed on 47 grossly obese patients. The results were disappointing in three patients who had a standard "14 in/4 in" Payne and DeWind procedure and therefore a more radical operation was performed, joining four inches (10.2 cm) of proximal jejunum to 10 inches (24.4 cm) of terminal ileum. Two years after the modified operation a mean of 44.2 kg had been lost and the weight tended to stabilize. This weight loss was due mainly to inadequate calorie intake. The appetite became more controlled so that if weight was regained this was small in amount. Metabolic sequelae and their symptoms also settled by two years. The physical, psychological, and social outcome was good. The postoperative period was stormy and required close medical and psychiatric supervision. There were two deaths.