Baddeley R M
Br J Surg. 1979 Aug;66(8):525-32. doi: 10.1002/bjs.1800660802.
Jejuno-ileal bypass has been performed in 226 massively obese patients, 190 of whom have been followed for a minimum of 1 year. End-to-side and end-to-end anastomoses were compared and no difference in the weight reduction achieved by either technique was seen throughout the 5-year follow-up. There was no significant difference in weight reduction achieved between groups of patients in which the jejunal length varied from 10 to 35 cm and the ileal length from 35 to 10 cm. The weight reduction achieved in the entire series averaged 36-7 +/- 9-4 per cent at 2 years, after which no further loss occurred. Good psychological benefits were recorded. Remission of diabetes occurred in 12 of 13 patients and marked long term lowering of serum lipids was seen. Side effects included fluid and electrolyte disturbances and fatty changes in the liver during the first year, improving thereafter. Early cirrhosis of the liver occurred in 8-6 per cent. Other side effects included abdominal bloating, arthralgia and renal colic. The operative mortality was 0-9 per cent and the late mortality directly attributable to the jejuno-ileal bypass, 3-1 per cent. In 19 patients the bypass was discontinued because of severe side effects.
已对226例极度肥胖患者实施了空肠回肠旁路手术，其中190例患者接受了至少1年的随访。比较了端侧吻合和端端吻合两种方式，在5年的随访期内，两种技术在减重效果上未发现差异。空肠长度在10至35厘米、回肠长度在35至10厘米的患者组之间，减重效果也无显著差异。整个系列患者在2年时的平均减重为36.7±9.4%，此后体重不再进一步下降。记录到该手术带来了良好的心理益处。13例患者中有12例糖尿病得到缓解，且出现了血清脂质的显著长期降低。副作用包括第一年出现的液体和电解质紊乱以及肝脏脂肪变性，之后有所改善。早期肝硬化的发生率为8.6%。其他副作用包括腹胀、关节痛和肾绞痛。手术死亡率为0.9%，直接归因于空肠回肠旁路手术的晚期死亡率为3.1%。19例患者因严重副作用而终止了旁路手术。
