Clinical trial of jejunoileal and gastric bypass for the treatment of morbid obesity: four-year progress report.

The present status of 38 patients comprising a clinical trial of jejunoileal and gastric bypass for the treatment of morbid obesity, begun four years ago at North Carolina Memorial Hospital, is reported. Weight loss was greater in patients treated by jejunoileal bypass than those treated by gastric bypass. The poorer weight loss noted in the gastric bypass patients is associated with an excessively large proximal gastric pouch, which had characterized the 19 gastric bypass operations done prior to May 1977. The weight loss achieved with the current version of the gastric bypass, a smaller proximal gastric pouch, is comparable to that achieved with jejunoileal bypass. The objective and subjective sequelae and complications of jejunoileal bypass are more common and more serious than those of gastric bypass. Gastric bypass is the better operation for the treatment of morbid obesity.