Which of the following gastrointestinal surgeries has the most detrimental effect on nutritional status?
  1. Jejunal resection
  2. Ileal resection
  3. Billroth I
  4. Billroth II
Explanation
Answer: B - Ileal resection, removal of part or all of the ileum, has the most detrimental effect on nutritional status because it causes decreased absorption of many nutrients, including fat-soluble vitamins, and interferes with bile salt activity needed for fat metabolism. In jejunal resection surgery, the ileum is able to compensate and take over some of the jejunum’s absorptive functions. The Billroth I and Billroth II surgeries are gastric resections in which part of the stomach is removed for the purpose of promoting weight loss. In both of these surgeries the small intestine is able to compensate and handle activities related to digestion and absorption.
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