Question:
I was just told that the j-i bypass surgery has been modified, does anyone know more?

I was talking to someone at the obesity clinic I had visited and was told that Dr.Cleator had revised the surgery in the past 7 years. That its a lot different, but now that I have heard so much bad about the surgery in general, I'm still scared to even concider it, even if it is a lot safer. I asked if they preformed any other weight loss surgeries and that was it. Would it be the safest to just completly forget about the j-i bypass, no matter if its revised or not? and go for something else? I can't believe how many options I'm finding about now. I'm truely overwhelmed.    — Betty S. (posted on February 1, 2000)

March 22, 2000
I too have researched many surgeries. I have met with and spoken to many folks who have had this surgery with this Doctor. They are healthy, happy and losing or finished losing. I have met people at various stages post op. All would not change a thing. The best thing they have done. There are side effects that diminish in the first few months. For some folks I am sure there have been bad experiences but that is true for each of the proceedures. These doctors have been travelling the world sharing their revised surgery with their peers. They are very excited about what they offer. Meet some folks who have actually had this surgery. They will tell you first hand. Don't always listen to people who are unfamiliar with the revised method. They worked years to come up with a viable revision and have been collecting stats etc. Hope this helps you in your quest.
   — Patty A.

March 22, 2000
This may be what you're referring to: <p> BILIOPANCREATIC DIVERSION: (BPD) <p> A modern variant of the Jejuno-ileal Bypass (JIB) is Biliopancreatic Diversion,(BPD), a procedure which differs from JIB in that no small intestine is defunctionalized and, consequently, liver problems are much less frequent. This procedure was developed by Professor Nicola Scopinaro, of the University of Genoa, Italy.(Scopinaro, Gianetta et al. 1996) <p> This procedure has two components. A limited gastrectomy results in reduction of oral intake, inducing weight loss, especially during the first postoperative year. The second component of the operation, construction of a long limb Roux-en-Y anastomosis with a short common "alimentary" channel of 50 cms length. This creates a significant malabsorptive component which acts to maintain weight loss long term. Dr Scopinaro recently published long term results of this operation, reporting 72% excess body weight loss maintained for 18 years. These are the best results, in terms of weight loss and duration of weight loss, reported in the bariatric surgical literature to this date. <p> From the patient's perspective, the great advantages of this operation are the ability to eat large quantities of food and still achieve excellent, long term weight loss results. Disadvantages of the procedure are the association with loose stools, stomal ulcers, offensive body odor and foul smelling stools and flatus. The most serious potential complication is protein malnutrition, which is associated with hypoalbuminemia, anemia, edema, asthenia, alopecia, generally requires hospitalization and 2 - 3 weeks hyperalimentation. BPD patients need to take supplemental calcium and vitamins, particularly Vitamin D, lifelong. Because of this potential for significant complications, BPD patients require lifelong follow-up. In BPD patients who have received 200 - 300 cm alimentary limbs because of protein malnutrition concerns, the incidence of protein malnutrition fell dramatically to range from 0.8% to 2.3% <P> Variants of this operation have been devised in an attempt to reduce the incidence of stomal ulceration and diarrhea using the techniques of sleeve resection of the stomach which maintains continuity of the gastric lesser curve and duodenal switch which maintains continuity of the gastro-duodeno-jejunal axis.(Marceau, Biron et al. 1993) This technique essentially eliminates stomal ulcer and dumping syndrome. <p> BPD and its variants are the most major procedures performed for obesity and it follows that prospective patients who wish to consider BPD should seek out experienced surgeons with life-long follow up programs. <P> Listing of complications of biliopancreatic diversion: <p> Protein Malnutrition 15% Incisional hernia 10% Intestinal obstruction 1% Acute biliopancreatic limb obstruction Stomal Ulcer 3.0% <p> Bone Demineralization: <p> Pre-op 25%; at 1-2 yrs, 29%; at 3-5 yrs 53%; at 6-10 yrs 14%. Hemorrhoids 4.3% Acne 3.5% Night Blindness 3% Operative Mortality 0.4% - 0.8% (1122 subjects, 1984-1993)
   — Victoria B.

March 22, 2000
If I were you, I would find out ALL the bad things about the original JIB, and then present the list to your surgeon, asking for an explanation of how the new and improved version addresses each risk. Best of luck!
   — Kim H.

April 15, 2002
Note... the Jejunoileal Bypass is NOT the same operation as the BPD. Just to clarify! So those stats mean nothing in relation to this surgery. :)
   — Nicole C.

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