Metabolic Intestinal Surgery

Its Complications and Management

Gene B. Starkloff, John F. Donovan, K. Ray Ramach, Bruce Wolfe

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

From November 1970 to August 1974 small intestinal bypass was performed in 475 patients for morbid obesity with an operative mortality of 1.6%. Immediate postoperative complications were superficial wound infection (17 patients), pulmonary complications (seven patients), cardiac complications (five patients), wound dehiscence (nine patients), intestinal tract fistula (four patients), and miscellaneous complications (14 patients). Delayed complications included hypokalemia (28%), hypocalcemia (9%), anemia (11%), calcium oxalate urinary calculi (6%), gout (2%), and hepatic failure (1.4%). Fourteen patients died of late complications. Ventral incisional hernia occurred in 3% of the patients; failure to lose sufficient weight in 21%, all but one occurring in patients with end-to-side shunts. Thirteen end-to-side shunts have been converted to end-to-end shunts because of insufficient weight loss. A team concept is important in the handling of the morbidly obese. Small bowel bypass is effective in producing sustained weight reduction in these patients. Careful and continued study of these patients for the rest of their lives is of paramount importance.

Original languageEnglish (US)
Pages (from-to)652-657
Number of pages6
JournalArchives of Surgery
Volume110
Issue number5
DOIs
StatePublished - 1975
Externally publishedYes

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Bariatric Surgery
Weight Loss
Jejunoileal Bypass
Ventral Hernia
Intestinal Fistula
Calcium Oxalate
Urinary Calculi
Hypokalemia
Morbid Obesity
Hypocalcemia
Gout
Liver Failure
Wound Infection
Anemia

ASJC Scopus subject areas

  • Surgery

Cite this

Metabolic Intestinal Surgery : Its Complications and Management. / Starkloff, Gene B.; Donovan, John F.; Ramach, K. Ray; Wolfe, Bruce.

In: Archives of Surgery, Vol. 110, No. 5, 1975, p. 652-657.

Research output: Contribution to journalArticle

Starkloff, Gene B. ; Donovan, John F. ; Ramach, K. Ray ; Wolfe, Bruce. / Metabolic Intestinal Surgery : Its Complications and Management. In: Archives of Surgery. 1975 ; Vol. 110, No. 5. pp. 652-657.
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