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Surgical Endoscopy

, Volume 31, Issue 4, pp 1882–1890 | Cite as

A short or a long Roux limb in gastric bypass surgery: does it matter?

  • Kemal Dogan
  • Jens Homan
  • Edo O. Aarts
  • Cees J. H. M. van Laarhoven
  • Ignace M. C. Janssen
  • Frits J. Berends
Article

Abstract

Background

The Roux-en-Y gastric bypass (RYGB) still remains the gold standard in bariatric surgery. However, no consensus exists on the optimal limb lengths to induce maximum weight reduction. The aim of the present study was to assess the effect of a longer alimentary limb (AL) length on weight reduction after RYGB.

Methods

A retrospective analysis of a prospectively collected database of patients who underwent a primary laparoscopic RYGB between January 2001 and March 2011 was performed. Patients received a short AL (SAL; 100 cm) or a long AL (LAL; 150 cm). Primary outcome was weight loss, and secondary outcomes were short- and long-term complication rates.

Results

A total of 768 patients received a RYGB during the study period. Of these, 730 consecutive patients were included for long-term analysis and had a mean follow-up (FU) of 37 ± 26 [range 0–120] months; 360 (47 %) patients received a SAL RYGB. Overall %TBWL was 33 ± 9 % after 2 years (FU 74 %) and 28 ± 12 % after 5 years (FU 20 %). No significant differences in %TBWL were found between SAL RYGB and LAL RYGB during the study period. The 30-day mortality rate was 0.13, 9 % overall short-term complication rate and 19 % cumulative long-term complication rate. No differences in complications were found between SAL and LAL RYGB patients.

Conclusion

Lengthening of the alimentary limb from 100 to 150 cm did not affect post-RYGB weight loss. Overall complication rates were low and comparable in this series of RYGB patients.

Keywords

Morbid obesity Roux-en-Y gastric bypass Laparoscopy Weight loss Complication Alimentary limb 

Notes

Acknowledgments

We would like to thank N. Ploeger (MANP) for collecting the prospective data.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Compliance with ethical standards

Disclosures

Drs. Kemal Dogan, Drs. Jens Homan, Dr. Edo Aarts, Prof. Dr. Cees van Laarhoven, Drs. Ignace Janssen, and Dr. Frits Berends have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kemal Dogan
    • 1
  • Jens Homan
    • 1
  • Edo O. Aarts
    • 1
  • Cees J. H. M. van Laarhoven
    • 2
  • Ignace M. C. Janssen
    • 1
  • Frits J. Berends
    • 1
  1. 1.Department of SurgeryRijnstate HospitalArnhemThe Netherlands
  2. 2.Department of SurgeryRadboud University Medical CentreNijmegenThe Netherlands

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