Partial ileal bypass surgery is a
surgical procedure
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
which involves shortening the
ileum
The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine ma ...
to shorten the total
small intestinal length.
First introduced in 1962 by Professor
Henry Buchwald
Henry Buchwald (born June 21, 1932) is an Austrian-American surgeon and academic. He is the Professor of Surgery and Biomedical Engineering and the Owen and Sarah Davidson Wangensteen Chair in Experimental Surgery Emeritus at the University of M ...
of the University of Minnesota, the procedure is used to treat a number of
hyperlipidemia
Hyperlipidemia is abnormally elevated levels of any or all lipids (fats, cholesterol, or triglycerides) or lipoproteins in the blood. citing: and The term ''hyperlipidemia'' refers to the laboratory finding itself and is also used as an umbre ...
s including
familial hypercholesterolemia
Familial hypercholesterolemia (FH) is a genetic disorder characterized by high cholesterol levels, specifically very high levels of low-density lipoprotein (LDL cholesterol), in the blood and early cardiovascular disease. The most common mutatio ...
.
The only
randomized controlled trial
A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical te ...
comparing bypass surgery with standard management was the POSCH trial, which was conducted by Buchwald and his team. The trial ran between 1975 and 1983 and included 838 men who had survived a
heart attack
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may tr ...
. This trial initially failed to show any benefit on mortality, but in 1998 follow-up results indicated that in addition to its known benefit on cholesterol levels and disease events it had also decreased mortality in the treatment group.
Ileal bypass surgery was mainly performed prior to the introduction of effective oral medication for the most common hypercholesterolemias.
It is occasionally used in the surgical treatment of
obesity
Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...
.
As with any ileal resection, a possible complication is mild
steatorrhea
Steatorrhea (or steatorrhoea) is the presence of excess fat in feces. Stools may be bulky and difficult to flush, have a pale and oily appearance, and can be especially foul-smelling. An oily anal leakage or some level of fecal incontinence may oc ...
due to a reduced uptake of bile acids by the ileum.
See also
*
Familial hypercholesterolemia
Familial hypercholesterolemia (FH) is a genetic disorder characterized by high cholesterol levels, specifically very high levels of low-density lipoprotein (LDL cholesterol), in the blood and early cardiovascular disease. The most common mutatio ...
*
Ileojejunal bypass The ileojejunal bypass is an experimental surgery designed as a remedy for morbid obesity.
It was first performed on a series of patients at White Memorial Hospital, Los Angeles, California
Los Angeles ( ; es, Los Ángeles, link=no , ), ...
References
{{Operations and other procedures on the digestive system
Digestive system surgery