Obesity Surgery

, Volume 29, Issue 11, pp 3665–3671 | Cite as

Outcomes of Long Pouch Gastric Bypass (LPGB): 4-Year Experience in Primary and Revision Cases

  • Rui Ribeiro
  • Sjaak PouwelsEmail author
  • Chetan Parmar
  • João Pereira
  • Leonor Manaças
  • Anabela Guerra
  • Nuno Borges
  • João Ribeiro
  • Octávio Viveiros
Original Contributions



One of the most important complications of the one anastomosis gastric bypass (OAGB) is enterobilio acid reflux (EBAR). We report the concept of the long pouch Roux-en-Y gastric bypass (LPRYGB) meaning a Roux-en-Y with a long pouch and a 100-cm alimentary limb to avoid EBAR, with a long biliopancreatic limb to increase metabolic effects.


A total of 300 LPRYGB cases in a 4-year period, with a 90% follow-up rate, were analysed. Anthropometric, technical feasibility, morbidity, weight loss and comorbidity outcomes were analysed.


The percentage total weight loss (%TWL) was 30.5% at 4 years of follow-up (32.3% in primary and 28.3% in revisions). Six intra-operative (2%) and 28 postoperative complications (9.3%) were seen. Out of this 28 complications, 11 (3.6%) were late complications. Reoperations were performed in 15 patients (5.0%). Clinically relevant EBAR was present in 3 cases only (1%) 4 years after the operation.


The LPRYGB combines the main advantages of the OAGB (light restriction and moderate malabsorption) with the anti-reflux effect from the Roux-en-Y diversion.


Long pouch gastric bypass LPGB Morbid obesity Biliary reflux Hypoglycaemia Roux-en-Y diversion Entero bilioacid reflux EBAR 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval Statement

An institutional review board approved this study.

Informed Consent Statement

Does not apply.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Clínica de Santo AntónioMetabolic Patient Multidisciplinary CentreLisbonPortugal
  2. 2.Department of SurgeryHaaglanden Medical CenterThe HagueThe Netherlands
  3. 3.Whittington HospitalLondonUK
  4. 4.Obesity and Endocrine Diseases Unit, Department of SurgeryCentro Hospitalar de Lisboa CentralLisbonPortugal

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