[20 years small intestinal bypass surgery. What is left?]

The jejunoileostomy was a frequently used surgical procedure to treat morbid obese patients (obesity grade III) from 1970 to 1980. The observed weight loss was very good, 50-60 kg during the first 18 months after operation (n = 288). Even obesity-induced side effects were improved significantly. However, negative consequences and complications were seen all too often: chronic loss of electrolytes, protein and vitamins and diarrhea with perianal skin problems. Reoperations were often necessary due to renal stone formation, cholecystolithiasis or blind loop syndrome. Therefore this procedure was abandoned in favor of operations such as vertical banded gastroplasty or the adjustable gastric band. However, in special cases similar operations may be helpful if gastric restriction has failed.