Surgical Management of Hyperlipidemia

Abstract

At the present time, there are three clinical surgical procedures that have been demonstrated to lower the circulating lipids: jejunoileal by-pass for management of morbid obesity, end-to-side portacaval shunt, and partial ileal by-pass. The primary purpose of jejunoileal by-pass is to achieve a caloric absorptive defect and subsequent weight reduction; an accompanying effect is plasma cholesterol and triglyceride lowering. Systemic diversion of the portal blood stream, long employed in the treatment of portal hypertension and esophageal varices, has been suggested as a therapeutic approach in the treatment of type IIa homozygous hyperlipoproteinemia in children. The partial ileal by-pass was designed specifically as a means to achieve cholesterol lowering.

Supported by National Heart and Lung Institute Grants HL 11901 and HL 15265 and a Special Legislative Appropriation of the State of Minnesota. Direct reprint requests to Dr. Henry Buchwald, Box 290, University of Minnesota Hospitals, Minneapolis, Minnesota 55455.