Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun;15(2):290-297.
doi: 10.5114/wiitm.2019.89774. Epub 2019 Nov 16.

The role of alimentary and biliopancreatic limb length in outcomes of Roux-en-Y gastric bypass

Sattar Darabi  1 , Abdoreza Pazouki  1   2 , Fatemeh Sadat Hosseini-Baharanchi  3 , Ali Kabir  1 , Mohammad Kermansaravi  1   2
Affiliations

The role of alimentary and biliopancreatic limb length in outcomes of Roux-en-Y gastric bypass

Sattar Darabi et al. Wideochir Inne Tech Maloinwazyjne. 2020 Jun.

Abstract

Introduction: Roux-en-Y gastric bypass (RYGB) is one of the safe and easily reproducible bariatric procedures.

Aim: To evaluate the effect of biliopancreatic limb (BPL) and alimentary limb (AL) length on weight loss outcomes after RYGB.

Material and methods: This retrospective cohort study included 313 morbidly obese patients who underwent primary laparoscopic RYGB 2009-2015. Patients' BPL and AL lengths were categorized into three groups: group 1 (BPL: 50 cm and AL: 150 cm), group 2 (BPL: 150 cm and AL: 50 cm), and group 3 (BPL: 100 cm and AL: 100 cm). Data were provided from the Iranian National Obesity Surgery Database. The generalized estimating equations method was used to assess the effect of limbs length on %excess weight loss (%EWL).

Results: Mean ± standard deviation age and body mass index (BMI) of 252 patients were 38.55 ±10.24 years and 45.8 ±4.77 kg/m2, respectively. Totally, 172 (68.3%, BMI of 46 ±5 kg/m2), 48 (19%, BMI of 45.12 ±4.26 kg/m2), and 32 (12.7%, BMI of 45.43 ±4.23 kg/m2) were in group 1, 2, and 3, respectively (p = 0.44). The results showed that the choice of different limb lengths had no significant effect on %EWL over 12 months follow-up (p = 0.625) adjusted for baseline BMI (p = 0.25). Mean %EWL in the patients with longer BPL and shorter AL was 5.43% (1.91, 8.95) higher in comparison to the patients with shorter BPL and longer AL during 36 months postoperatively adjusted for baseline BMI (p = 0.002).

Conclusions: During 12 months after RYGB, %EWL was not associated with BPL or AL length. However, during 36 months postoperatively, the patients with longer BPL had a significantly higher %EWL in comparison to the patients with shorter BPL.

Keywords: Roux-en-y gastric bypass; alimentary limb; biliopancreatic limb; generalized estimating equations; weight loss.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The trend of %EWL of the patients in three groups during 36 months follow-up
See this image and copyright information in PMC

References

    1. Hernández-Martínez J, Calvo-Ros MÁ. Gastric by-pass with fixed 230-cm-long common limb and variable alimentary and biliopancreatic limbs in morbid obesity. Obes Surg. 2011;21:1879–86. - PubMed
    1. Thurnheer M, Bisang P, Ernst B, et al. A novel distal very long Roux-en Y gastric bypass (DVLRYGB) as a primary bariatric procedure – complication rates, weight loss, and nutritional/metabolic changes in the first 355 patients. Obes Surg. 2012;22:1427–36. - PubMed
    1. Welbourn R, Pournaras DJ, Dixon J, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Second IFSO Global Registry Report 2013–2015. Obes Surg. 2017:1–10. - PubMed
    1. Schijns W, Ligthart MA, Berends FJ, et al. Changes in iron absorption after roux-en-Y gastric bypass. Obes Surg. 2018;28:1738–44. - PubMed
    1. Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94. - PubMed