Liver biopsy findings in seventy-seven consecutive patients undergoing jejunoileal bypass for morbid obesity

To clarify the status of hepatic morphology existent at the time of jejunoileal bypass in morbidly obese patients (those more than 100 pounds overweight) and the subsequent changes in liver architecture after jejunoileal bypass, we are performing intraoperative and yearly postoperative liver biopsies in all of our patients managed in this manner. This is the first report of our liver studies and this paper is an analysis of the histologic aspects of the liver at the time of bypass in seventy-seven consecutive patients. This study clearly demonstrates that the majority of markedly obese patients undergoing jejunoileal bypass have fatty metamorphosis of the liver at the time of their operative procedure. Previous similar reports from the literature are reviewed, and theories for the origin of hepatic fatty infiltration in obesity per se and after jejunoileal bypass are discussed.