Partial ileal bypass surgery is a surgical procedure 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 m ...

to shorten the total small intestinal length. First introduced in 1962 by Professor Henry Buchwald 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 umbr ...

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 mutati ...

. 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 ...

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 m ...

. 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 ...

. 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 ...

due to a reduced uptake of bile acids by the ileum.

References

{{Operations and other procedures on the digestive system Digestive system surgery

See also

References