Effects of Jejunocolic Shunt on Obesity, Serum Lipoproteins, Lipids, and Electrolytes

IN OBESE PATIENTS who have undergone jejunocolic shunt, there is decreased intestinal absorption, especially of fats, associated with reduced levels of serum cholesterol and of β-lipoproteins. The decrease in serum lipids has persisted for as long as six years after operation and five years after the weight of the patient has become stabilized near normal. Materials and Methods Eleven grotesquely fat patients, whose obesity was due to excessive caloric intake, and who had been unable to reduce, were selected for surgical treatment. Surgical Technique. —The difficult task of anesthetizing the patients was first undertaken.* The force required for ventilation in an extremely obese patient is much greater in the supine position than the upright. Because of this difficulty cyclopropane was administered by a large cuffed endotracheal tube; d-tubocurarine was used as a muscle relaxant, especially to facilitate positive-pressure breathing. The abdomen was opened through a high right paramedian incision. The