Dean R H, Scott H W, Shull H J, Gluck F W
Am J Clin Nutr. 1977 Jan;30(1):90-7. doi: 10.1093/ajcn/30.1.90.
A review of the problems associated with extensive jejunoileal bypass for morbid obesity in a series of 175 carefully selected patients is presented. Five postoperative deaths occurred (3%). Nonfatal complications occurred in 21%, with wound infections (14 patients) being the most common. Good results marked by weight reduction to the range of ideal weight without significant electrolyte or metabolic aberrations was observed in 82% of the patients receiving the current dimensional modificatiom of end-to-end jejunoileal bypass (30 cm to 20cm). An additional 13% had fair results and only 5% had poor results. There were six deaths during follow-up: liver failure in four patients (secondary to alcohol abuse in two), myocardial infarction in one, and one from unknown causes. Bypass reversal was necessary for refractory liver failure in three patients (two from alcohol abuse), and for persistent diarrhea with secondary electrolyte depletion in two patients. One of these patients was complicated by severe emotional instability. This experience suggests that the majority of carefully selected patients will have a good response to jejunoileal bypass.
本文对175例经过精心挑选的病态肥胖患者进行广泛空肠回肠旁路术相关问题进行了回顾。术后发生5例死亡（3%）。21%出现非致命性并发症，其中伤口感染（14例患者）最为常见。在接受当前端对端空肠回肠旁路术尺寸修改（从30厘米改为20厘米）的患者中，82%取得了良好效果，体重减轻至理想体重范围，且无明显电解质或代谢异常。另外13%效果尚可，只有5%效果不佳。随访期间有6例死亡：4例患者死于肝衰竭（其中2例继发于酒精滥用），1例死于心肌梗死，1例死因不明。3例患者（2例继发于酒精滥用）因难治性肝衰竭需要进行旁路逆转，2例患者因持续性腹泻伴继发性电解质耗竭需要进行旁路逆转。其中1例患者并发严重情绪不稳定。该经验表明，大多数经过精心挑选的患者对空肠回肠旁路术会有良好反应。
