Gastric bypass in the operative revision of the failed jejunoileal bypass

Fifty-five patients with failed jejunoileal bypasses underwent reanastomosis and gastric bypass at the same operation. One patient died of undetermined cause three months postoperatively. The 54 surviving patients were all relieved of their preoperative symptoms, and 40 patients achieved satisfactory weight control. Technical complications prevented weight loss in 13 patients: four were given pouches too large to be effective, and nine had late disruption of the staple line. Two patients gained weight despite the fact that their pouches were of appropriate size. Reanastomosis will reverse the side effects of jejunoileal bypass, and a properly performed gastric bypass at the same operation will afford protection against subsequent weight gain.