GASTRO-JEJUNO-ILEAL BYPASS: A VALID ALTERNATIVE TO BILIOINTESTINAL BYPASS

Background: Biliointestinal bypass (BIBP) is our malabsorptive bariatric procedure of choice. In cholecystectomized patients, we perform gastro-jejuno-ileal bypass(GJIBP), where the excluded jejunum was joined to gastric fundus. Methods: 10 patients, 9 female and 1 male, mean age 45 (35- 57) years, mean weight 141 (98-207) kg, mean BMI 52 (40-67) kg/m2, mean follow-up 18 months. We performed anastomosis between 30 cm of jejunum and 15-20 cm of distal ileum. The excluded jejunum was connected to gastric fundus close to the cardias with 21-25 circular stapler in order to prevent a blind loop. Results: 12 months postoperatively mean weight was 118 (86- 151) kg, mean BMI was 42 (33-52) kg/m2. In the early postoper- ative period, one patient showed electrolyte unbalance as a con- sequence of severe diarrhea and another patient complained of an anal fissure. No patient reported abdominal bloating. There was no death. Conclusion: Our preliminary experience showed that after GJIBP, the weight loss was satisfactory in all patients. The good results, the poor rate of complications and lack of abdominal bloating suggest that this procedure in patients with previous cholecystectomy is a valid malabsorptive option.