[Surgical therapy of obesity]

The experimental series by dogs and pigs show no specific absorption place in the small intestine--except the high selective absorption of vitamin B12 in the last ileum loop. Potassium absorption is better in the upper jejunum. For all other substances the conditions for absorption are the same in the jejunum as in the ileum. Calcium, carotin and cholesterol need a sufficiently extensive surface and show therefore a direct relation to the length of the small intestine. For the treatment of the extreme obesity we perform the jejunoileostomy with different lengths of jejunum and ileum. The hypercholesterinaemia type II can be treated by a partial ileum bypass. By the diminished absorption of the bile salts a sufficient decrease of the cholesterol level is possible, which amounts to about half the earlier value. The jejunoileostomy reduces not only overweight, but also improves the carbohydrate metabolism and lowers the increased fat levels.