Surgical Alternatives for the Short Bowel Syndrome

Jon S Thompson, L. F. Rikkers

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Since the introduction of total parenteral nutrition an increasing number of patients are surviving massive intestinal resection. However, the expense, morbidity, and inconvenience of this therapy have created interest in surgical alternatives for the treatment of the short bowel syndrome‐ The goals of surgical therapy in the short bowel syndrome are to slow intestinal transit, increase the area of absorption, and reduce gastric hyperacidity. Antiperistaltic segments or colon interposition benefit patients with sufficient absorptive area, hut rapid intestinal transit. Intestinal valves yield inconsistent results. Recirculating loops are associated with prohibitive morbidity and mortality. Experience with intestinal pacing is limited. Patients with dilated bowel segments may benefit from intestinal tapering or lengthening. Growing neomucosa holds promise hut has not been evaluated clinically. Despite recent advances in immunosuppression the results of transplantation remain unsatisfactory. Gastric hyperacidity can be effectively controlled by H2 receptor antagonists. None of the operations for treatment of the short bowel syndrome is sufficiently safe and effective to recommend their routine use. Operations should he performed only on selected patients to achieve specific goals. Although investigation continues, our emphasis should continue to be prevention of intestinal resection and conservation of as much of the intestine as possible when massive resection is necessary.

Original languageEnglish (US)
Pages (from-to)97-106
Number of pages10
JournalThe American journal of gastroenterology
Volume82
Issue number2
DOIs
StatePublished - Jan 1 1987

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Short Bowel Syndrome
Antidiarrheals
Morbidity
Histamine H2 Receptors
Total Parenteral Nutrition
Therapeutics
Immunosuppression
Intestines
Stomach
Colon
Transplantation
Mortality

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Surgical Alternatives for the Short Bowel Syndrome. / Thompson, Jon S; Rikkers, L. F.

In: The American journal of gastroenterology, Vol. 82, No. 2, 01.01.1987, p. 97-106.

Research output: Contribution to journalArticle

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