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Treatment of familial hypercholesterolaemia by partial ileal bypass
Insights
Partial ileal bypass surgery significantly reduces high cholesterol in familial hypercholesterolaemia patients. While effective, the procedure carries risks and should be reserved for carefully selected individuals.
Area of Science:
- Cardiovascular Medicine
- Surgical Gastroenterology
Background:
- Familial hypercholesterolaemia (FH) is a genetic disorder causing severely elevated cholesterol levels.
- Fredrickson type II describes the commonest form of FH, characterized by high LDL cholesterol.
- Effective long-term management strategies for FH are crucial.
Abstract:
Ten patients with heterozygous familial hypercholesterolaemia (Fredrickson type II) were treated by the operation of partial ileal bypass. Postoperatively, serum cholesterol levels fell by an average of 34% (P less than 0.005), and the decrease was satisfactorily sustained over a period of 12-30 months. Angina and xanthomas also improved in some patients. Postoperatively all patients experienced considerable diarrhoea, which lessened with time. Other complications of surgery included abdominal distension and cramps, colonic dilatation, sepsis and intestinal obstruction. It is concluded that partial ileal bypass significantly lowers serum cholesterol levels, but that in view of the complications the operation should be offered only to carefully selected patients who are intolerant of or unresponsive to conservative measures.