[Intestinal by-pass for obesity (author's transl)]

Obese people, more than 45 kg above their ideal weight, can be treated by an intestinal by-pass. This operation must be reserved for patients where conservative treatment failed, where there is no organic origin, and given the operative risk be not increased by underlying serious disease. Good pre- and postoperative collaboration of the patient together with clinical and biological controls are essential. The operation consists of an end-to-side jejuno-ileostomy with proximal suture of the blind loops; or an end-to-end jejuno-ileostomy with implantation of the blind loops in the colon. Loss of weight to near ideal plus improvement of diabetes, hypertension, gout and hyperlipaemia can be expected. Diarhea will occur for a few months or one year. Biochemical values usually remain stable: values for lipids decrease to lower normal if elevated before the operation. During fast weight loss, there are changes in the liver structure and hepatic tests; these are transient and reversible.