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Impact of Biliopancreatic Limb Length (70 cm vs 120 cm), with Constant 150 cm Alimentary Limb, on Long-Term Weight Loss, Remission of Comorbidities and Supplementation Needs After Roux-En-Y Gastric Bypass: a Prospective Randomized Clinical Trial

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Abstract

Background

The best alimentary and biliopancreatic limb (BPL) lengths in the Roux-en-Y gastric bypass (RYGB) still remain unclear. The aim of this study was to compare the effect of a BPL of 70 vs 120 cm, with a constant AL of 150 cm on long-term weight loss, remission of comorbidities, and supplementation needs after RYGB.

Patients and Methods

A prospective randomized study of morbidly obese patients undergoing RYGB was performed. Patients were randomized into two groups: those patients undergoing RYGB with a BPL of 70 cm (BPL 70 cm) and those ones undergoing RYGB with a BPL of 120 cm (BPL 120 cm). BMI, excess BMI loss (EBMIL), remission of comorbidities and specific vitamin and mineral supplementation needs at 1, 2, and 5 years were analyzed.

Results

Two hundred fifty-three patients were included in each group. There were no significant differences in BMI, EBMIL and the remission of diabetes mellitus, hypertension, and dyslipidemia between groups at 1, 2, and 5 years after surgery. Patients from group BPL 120 cm required greater specific supplementation of vitamin B12, folic acid, and vitamin A during all the follow-up.

Conclusion

A RYGB with 120 cm BPL does not achieve greater weight loss or remission of comorbidities than a RYGB with 70 cm BPL but is associated with greater deficiencies of vitamin B12, vitamin A, and folic acid.

Trial Registration

ClinicalTrials.gov Identifier NCT03607305. https://clinicaltrials.gov/.

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Authors and Affiliations

  1. Centro de Excelencia para el Estudio y Tratamiento de la Obesidad, Valladolid, Spain

    Jaime Ruiz-Tovar

  2. Madrid, Spain

    Jaime Ruiz-Tovar

  3. Department of Surgery, Hospital Universitario Fundación Jimenez Diaz, Madrid, Spain

    Peter Vorwald, María Posada & Damian Garcia-Olmo

  4. Department of Bariatric Surgery. Hospital Angeles del Carmen, Universidad de Guadalajara, Guadalajara, Mexico

    Gilberto Gonzalez-Ramirez & Gabriel Salcedo

  5. Department of Surgical Nursery, Hospital del Sureste, Madrid, Spain

    Carolina Llavero

Authors
  1. Jaime Ruiz-Tovar
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  2. Peter Vorwald
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  3. Gilberto Gonzalez-Ramirez
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  4. María Posada
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  5. Gabriel Salcedo
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  6. Carolina Llavero
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  7. Damian Garcia-Olmo
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Correspondence to Jaime Ruiz-Tovar.

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Statement of Informed Consent

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

Statement of Human Rights

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Ruiz-Tovar, J., Vorwald, P., Gonzalez-Ramirez, G. et al. Impact of Biliopancreatic Limb Length (70 cm vs 120 cm), with Constant 150 cm Alimentary Limb, on Long-Term Weight Loss, Remission of Comorbidities and Supplementation Needs After Roux-En-Y Gastric Bypass: a Prospective Randomized Clinical Trial. OBES SURG 29, 2367–2372 (2019). https://doi.org/10.1007/s11695-019-03717-7

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  • DOI: https://doi.org/10.1007/s11695-019-03717-7

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