Bilio-intestinal shunt. A method and a pilot study for treatment of obesity.

Diarrhea is a drawback in all types of small intestinal bypass operations for the treatment of morbid obesity. One of the causes of diarrhea is excessive amounts of bile acids in the colon. Therefore in five obese subjects, we complemented the usual jejuno-ileostomy end to side procedure with an anastomosis between the proximal end of the excluded blind loop and the gallbladder (bilio-intestinal shunt). In this way the enterohepatic circulation of bile acids is assumed to be preserved. The patients, subjected to this new methods, were compared to matched patients (age, sex, height, preoperative body-weight, Brocas index and total small intestinal length) following four other types of jejuno-ileostomies. The frequency of diarrhea in the subjects with the bilio-intestinal shunt was significantly less than in the other groups. Other parameters, such as rate and magnitude of weight reduction, changes in blood cholesterol and triglycerides, were the same in the control groups.