Of course your case report is dramatic and I can easily imagine why you wouldn't want to do them, but, as you say, it is only a case report. It in no way incriminates the procedure. I'm sure many of you are aware that morbid obesity is a bad disease, even if it is "self-induced." In spite of the short term successes of the various diets, medical treatment of obesity almost invariably fails. Surgery has been shown to be the ONLY successful treatment of obesity. Unfortunately surgery has its own risks and complications which must be considered. Surgery of morbid obesity is fraught with hazard, and should be undertaken only in intelligent well-informed patients. Especially since the patients are otherwise healthy and theoretically don't need an operation at all.
The Scopinaro procedure is basically a variation on the JI bypass. The JI bypass causes problems because there is a long defunctionalized segment of small bowel which is thought to develop bacterial overgrowth, leading to liver dysfunction and, in some patients, cirrhosis. The Scopinaro procedure is an attempt to avoid this problem by directing biliary and pancreatic secretions through the otherwise defunctionalized limb. A long roux-en-y limb is created, whereby gastric contents are sent through the other limb of the Y. The two limbs join about 50 cm. from the cecum, allowing partial digestion of the food. There is fairly good absorption of protein and carbohydrates, and relative malabsorption of fat. The operation also includes hemigastrectomy to prevent anastomotic ulcers, as well as cholecystectomy to prevent gallstone formation, which would otherwise occur in about 50% of patients.Patients must be maintained on additional vitamins and minerals for life. Most patients lose 80% of excess weight.
This was not meant to be a comprehensive explanation. I will find some references and post them here later.