JEJUNO-COLIC BYPASS

As part of an ongoing study of morbid obesity, Payne et al. reported results of ten patients in whom an end-to-side jejuno-colic shunt had been performed.(Payne, DeWind et al. 1963) In jejuno-colic shunt, the upper small bowel was joined even futher down the intestinal tract, to the colon, with the idea of bypassing an even longer segment of the nutrient absorptive gastrointestinal tract. These patients had episodes of uncontrollable diarrhea, dehydration and electrolyte imbalance. Because of the problem with diarrhea, most of these surgeries were eventually taken down and converted to end-to-side jejunoileostomies. Payne and Dewind subsequently advised against jejunocolic anastomoses, instead recommending end to side jejuno-ileostomy anastomosing the first 14 inches of jejunum to the last 4 inches of ileum.(Payne and DeWind 1969)