Small Bowel Limb Lengths and Roux-en-Y Gastric Bypass: a Systematic Review
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There is currently no consensus on the combined length of small bowel that should be bypassed as biliopancreatic or alimentary limb for optimum results with Roux-en-Y gastric bypass. A number of different limb lengths exist, and there is significant variation in practice amongst surgeons. Inevitably, this means that some patients have too much small bowel bypassed and end up with malnutrition and others end up with a less effective operation. Lack of standardisation poses further problems with interpretation and comparison of scientific literature. This systematic review concludes that a range of 100–200 cm for combined length of biliopancreatic or alimentary limb gives optimum results with Roux-en-Y gastric bypass in most patients.
KeywordsBariatric surgery Gastric bypass Small bowel limb length Biliopancreatic limb Alimentary limb Roux limb Roux-en-Y gastric bypass Small bowel length Obesity
Total small bowel length
Roux-en-Y gastric bypass
National Bariatric Surgery Registry
Body mass index
Small bowel length
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Excess weight loss
Distal gastric bypass
Proximal gastric bypass
Biliopancreatic limb-based distal gastric bypass
Alimentary limb-based distal gastric bypass
Extended limb proximal gastric bypass
Standard proximal gastric bypass
Short limb proximal gastric bypass
Total parenteral nutrition
KM conceived the idea for the topic. KM and PK independently collected information and analysed it. All authors participated in departmental discussion on the topic and manuscript writing. All authors have seen the final version and approve of it.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
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- 2.Welbourn R, Small P, Finlay, I, Sarela A, Somers S, Mahawar K. Second National Bariatric Surgery Report. http://www.bomss.org.uk/wp-content/uploads/2014/04/Extract_from_the_NBSR_2014_Report.pdf Last Accessed on 22nd August’ 2015.
- 4.Svanevik M, Risstad H, Hofsø D, et al. Perioperative outcomes of proximal and distal gastric bypass in patients with BMI ranged 50–60 kg/m2—a double-blind, randomized controlled trial. Obes Surg. 2015 Mar 12. [Epub ahead of print].Google Scholar
- 50.Raines D, Arbour A, Thompson HW, et al. Variation in small bowel length: factor in achieving total enteroscopy? Dig Endosc. 2014 May 26. doi: 10.1111/den.12309. [Epub ahead of print].