Surgical considerations in the short bowel syndrome

The surgical management of patients with short bowel syndrome (SBS) should aim to minimize the development of predictable complications, improve quality of life, and enhance patient survival. In some cases, these efforts begin in the preoperative period prior to SBS. Prevention of SBS would be ideal given the morbidity and mortality associated with long-term treatment. There are intraoperative strategies to be employed at the initial operation and any subsequent reoperation. Postoperative management of SBS and surgical rehabilitation, procedures intended to improve intestinal function, also have a profound effect on overall outcome. In this chapter, we review the preoperative, intraoperative, and postoperative strategies that can be utilized to optimize the chance for the best outcome. Additionally, surgical aspects of selected gastrointestinal (GI) complications occurring in SBS patients are discussed.