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The Role of Gastrojejunostomy Size on Gastric Bypass Weight Loss

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Abstract

Background

The laparoscopic Roux-en-Y gastric bypass (LRYGB) has been considered a reference procedure in the bariatric surgery. The linear-stapled gastrojejunostomy (GJ) has proved to be safe and effective, but its optimal size referred to postoperative weight loss remains poorly understood.

Objectives

Evaluate the role of the linear-stapled GJ size in the mid-term post-LRYGB weight loss and occurrence of complications.

Materials and Methods

From January to April 2014, 128 patients underwent LRYGB with linear-stapled GJ in a 2-year follow-up. The LRYGB were carried out with the same technical steps, except for the length of the GJ. In GJ-15-mm group (n = 64), the GJ was constructed with white 45-mm cartridge in an extension of only 15 mm whereas in GJ-45-mm group (n = 64), the GJ was achieved using full extension of the cartridge. The body mass index (BMI) reduction was recorded for 24 months after procedure.

Results

The mean ages were 38 ± 10.6 and 41.3 ± 12.3 years, and there were 45 (70.3%) and 51 (79.7%) females in the GJ-15-mm and GJ-45-mm groups, respectively. The analysis on raw BMI data showed that both groups had significant reduction of BMI over time (p ≤ 0.05); however, reduction was greater in the GJ-15-mm group from 18 months onwards (p ≤ 0.05). The only complication observed was a case (1.56%) of stenosis in the group GJ-15 mm.

Conclusion

The global analysis of BMI reduction indicated that the narrower GJ used (GJ-15-mm group) represented a favoring factor decreasing significantly more the BMI when compared to the wider one (GJ-45-mm group).

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Acknowledgements

The authors would like to acknowledge the Postgraduate Surgery Program of the Federal University of Pernambuco as this study was accepted to achieve PhD proficiency.

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Authors and Affiliations

  1. Postgraduate Surgery Program, Federal University of Pernambuco, Recife, Brazil

    Almino Cardoso Ramos, Maíra Danielle Gomes de Souza, Josemberg Marins Campos & Alvaro Bandeira Ferraz

  2. Gastro-Obeso-Center-Advanced Institute for Digestive and Bariatric Surgery, Sao Paulo, Brazil

    Almino Cardoso Ramos, Eduardo Lemos de Souza Bastos & Manoela Galvão Ramos

  3. Marchesini Institute, Curitiba, Brazil

    João Caetano Marchesini

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  1. Almino Cardoso Ramos
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  2. João Caetano Marchesini
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  3. Eduardo Lemos de Souza Bastos
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  4. Manoela Galvão Ramos
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  5. Maíra Danielle Gomes de Souza
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  6. Josemberg Marins Campos
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  7. Alvaro Bandeira Ferraz
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Correspondence to Almino Cardoso Ramos.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study has been approved by local Institution Review Board and performed in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Ramos, A.C., Marchesini, J.C., de Souza Bastos, E.L. et al. The Role of Gastrojejunostomy Size on Gastric Bypass Weight Loss. OBES SURG 27, 2317–2323 (2017). https://doi.org/10.1007/s11695-017-2686-6

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  • DOI: https://doi.org/10.1007/s11695-017-2686-6

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