I. Apologia

The authors have now had ten years of clinical experience with the partial ileal bypass operation for management of the hyperlipidemias. The human trial was preceded by and has been continuously complemented by research in the animal laboratory in an effort to provide a metabolic data base which will facilitate understanding of the rationale and effects of this means of lipid lowering therapy. In addition, the determination of cholesterol dynamics as influenced by partial ileal bypass has been studied in the clinical setting. Other independent investigators have published in this field confirming and extending our findings and, at times, differing in their results and conclusions. We have attempted both to review the extensive past literature in this area and to add previously unpublished original material in a three-part presentation: Part I, Apologia; Part II, Laboratory Experience; and Part III, The Clinical Status of the Partial Ileal Bypass Operation. At a time when the medical community must come to grips with the question of whether lipid lowering will influence the atherosclerotic risk rate, this task was undertaken in order to offer a comprehensive overview of what are the effective and safe means available to achieve lipid reduction.