Partial ileal bypass surgery

Partial ileal bypass surgery is a surgical procedure which involves shortening the ileum to shorten the total small intestinal length.cite journal |author=Buchwald H, Stoller DK, Campos CT, Matts JP, Varco RL |title=Partial ileal bypass for hypercholesterolemia. 20- to 26-year follow-up of the first 57 consecutive cases |journal=Ann. Surg. |volume=212 |issue=3 |pages=318–29; discussion 329–31 |year=1990 |month=September |pmid=2396883 PMC|1358164]

First introduced in 1962 by Professor Henry Buchwald of the University of Minnesota, [cite journal |author=Buchwald H |title=Lowering of cholesterol absorption and blood levels by ileal exclusion. Experimental basis and preliminary clinical report |journal=Circulation |volume=29 |issue= |pages=713–20 |year=1964 |month=May |pmid=14156865 |url=http://circ.ahajournals.org/cgi/reprint/29/5/713 | format=PDF] the procedure is used to treat a number of hyperlipidemias including familial hypercholesterolemia.cite journal |author=Buchwald H, Moore RB, Varco RL |title=Ten years clinical experience with partial ileal bypass in management of the hyperlipidemias |journal=Ann. Surg. |volume=180 |issue=4 |pages=384–92 |year=1974 |month=October |pmid=4416064 PMC|1344105] cite journal |author=Chalstrey LJ, Winder AF, Galton DJ |title=Partial ileal bypass in treatment of familial hypercholesterolaemia |journal=J R Soc Med |volume=75 |issue=11 |pages=851–6 |year=1982 |month=November |pmid=7143333 PMC|1438421] The only randomized controlled trial 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. 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. [cite journal |author=Buchwald H, Varco RL, Boen JR, "et al" |title=Effective lipid modification by partial ileal bypass reduced long-term coronary heart disease mortality and morbidity: five-year posttrial follow-up report from the POSCH. Program on the Surgical Control of the Hyperlipidemias |journal=Arch. Intern. Med. |volume=158 |issue=11 |pages=1253–61 |year=1998 |month=June |pmid=9625405 |doi= |url=http://archinte.ama-assn.org/cgi/content/full/158/11/1253]

Ileal bypass surgery was mainly performed prior to the introduction of effective oral medication for the most common hypercholesterolemias.cite journal |author=Durrington P |title=Dyslipidaemia |journal=Lancet |volume=362 |issue=9385 |pages=717–31 |year=2003 |pmid=12957096] It is occasionally used in the surgical treatment of obesity. [cite journal |author=Buchwald H, Avidor Y, Braunwald E, "et al" |title=Bariatric surgery: a systematic review and meta-analysis |journal=JAMA |volume=292 |issue=14 |pages=1724–37 |year=2004 |month=October |pmid=15479938 |doi=10.1001/jama.292.14.1724 |url=http://jama.ama-assn.org/cgi/content/full/292/14/1724]

ee also

*Familial hypercholesterolemia

References