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Comparing a Short Biliopancreatic Limb to a Long Biliopancreatic Limb in Patients with a Roux-en-Y Gastric Bypass with 4 Years Follow-up

Obesity Surgery volume 31, pages 4846–4852 (2021)Cite this article

Abstract

Introduction

In order to design the most effective weight loss procedure, the ideal biliopancreatic limb (BPL) and alimentary limb (AL) length in Roux-en-Y gastric bypass (RYGB) have been discussed extensively. Yet, no consensus has been reached. The aim of this study was to compare weight loss after a short and long BPL in patients who underwent a RYGB with a minimum of 4 years follow-up.

Methods

This retrospective cohort study consisted of 574 patients who underwent a primary RYGB procedure between March 2015 and January 2017. Patients were divided in two groups based on the surgical procedure performed: a short BPL group (BPL of 50 cm with an AL of 150 cm) and long BPL group (BPL of 150 cm with an AL of 75 cm). The percentage total weight loss (%TWL) between groups was compared up to 4 years after surgery. Secondary outcomes were 30-day postoperative complications and health-related quality of life (RAND-36).

Results

The short BPL group consisted of 286 patient and the long BPL group of 288 patients. Follow-up rates of both groups at the first, second, third, and fourth year after surgery were comparable. The long BPL group showed significantly more %TWL compared to the short BP limb group starting at 6 months (p = 0.004) until 4 years after surgery (p < 0.001). Thirty-day complications and health-related quality of life did not differ.

Conclusion

The results showed significantly more %TWL in patients receiving a long BPL compared to the short BPL up to 4 years after surgery.

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Authors and Affiliations

  1. Department of Surgery, OLVG Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands

    Leontien M. G. Nijland, Joris M. van Sabben, Hendrik A. Marsman, Ruben N. van Veen & Steve M. M. de Castro

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  1. Leontien M. G. Nijland
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  2. Joris M. van Sabben
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  3. Hendrik A. Marsman
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  4. Ruben N. van Veen
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  5. Steve M. M. de Castro
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Correspondence to Steve M. M. de Castro.

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This study has been approved by the institutional research ethics committee and all procedures have been performed in accordance with the Declaration of Helsinki originally adopted in 1964 and its later amendments or comparable ethical standards. For this type of study, formal consent was not required.

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The authors declare no competing interests.

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Nijland, L.M.G., van Sabben, J.M., Marsman, H.A. et al. Comparing a Short Biliopancreatic Limb to a Long Biliopancreatic Limb in Patients with a Roux-en-Y Gastric Bypass with 4 Years Follow-up . OBES SURG 31, 4846–4852 (2021). https://doi.org/10.1007/s11695-021-05651-z

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Keywords

  • Roux-en-Y gastric bypass
  • Weight loss
  • Biliopancreatic
  • Limb length