Articular complications in obese patients after jejunocolic bypass

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Jejunocolic shunt was introduced in 1956 as an effective method in treating massive obesity.1–2 Although weight loss after this operation was dramatic, the operation was abandoned because of multiple, occasionally fatal complications.1, 3–9 Joint disease was a significant problem in our experience with 27 obese patients.

Polyarthralgias and polyarthritis developed in eight of these after a jejunocolic shunt procedure.

Patients and results

Between 1959 and 1968, jejunocolic shunt was performed in 27 obese patients at the Cleveland Clinic Hospital. The jejunum was transected 76 cm from the ligament of Treitz. The proximal end was anastomosed end-to-side to the mid-transverse colon (in one case to the ascending colon). In 15 patients, the distal jejunum was brought to the abdominal wall. A silastic tube was secured to it, making a jejunostomy available for fluid and electrolyte replacement.

There were 19 women and eight men; ages ranged between 22 and 47 years (average 33). Preoperative weights were between 102.8 kg and 204.3 kg (average 151.9 kg). Five patients were lost to follow-up between 1 and 59 months postoperatively (average 16.6). Six patients died 10 days to 62 months after surgery. Thirteen patients had take-down of their jejunocolic shunts 9 to 135 months postoperatively (average 44.1). Three patients still have the shunts 6 years and 2 months, 6 years and 7 months, and 9 years and 10 months after the operation.

Weight loss averaged 57.2 kg per person, the maximum weight loss was 126.7 kg. It was particularly marked in the 12th. . .



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