Brief History and Summary of Bariatric Surgery
The first operations designed solely for the purpose of weight loss were initially performed in the 1950s at the University of Minnesota. The jejunoileal bypass (JIB) induced a state of malabsorption by bypassing most of the intestines while keeping the stomach intact. Although the weight loss with the JIB was good, too many patients developed complications such as diarrhea, night blindness (from vitamin A deficiency), osteoporosis (from vitamin D deficiency), protein-calorie malnutrition, and kidney stones. Some of the most worrisome complications were associated with the toxic overgrowth of bacteria in the bypassed intestine. These bacteria then caused liver failure, severe arthritis, skin problems, and flu-like symptoms. Consequently, many patients have required reversal of the procedure.
The JIB is no longer a recommended bariatric surgical procedure. The lessons learned from the JIB include the crucial importance of long-term follow-up and the dangers of a permanent, severe and global malabsorption. Long-term follow-up by experienced bariatric surgeons is strongly recommended for all patients who have had a JIB in the past.
Kremen, AJ, Linner JH, et al. An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg 1954;140:439-48.
Griffen Jr, WO, Bivins, BA, et al. The decline and fall of jejunoileal bypass. Surg Gynecol Obstet 1983;157:301-8.
Click on the links below to Jump to a Section of the Story
• Chapter 1. INTRODUCTION
• Chapter 2. JEJUNOILEAL BYPASS
• Chapter 3. GASTRIC BYPASS & LAPAROSCOPIC GASTRIC BYPASS
• Chapter 4. BILIOPANCREATIC DIVERSION DUODENAL SWITCH
• Chapter 5. GASTROPLASTY
• Chapter 7. ON THE HORIZON & SUMMARY