Skip to main content
SpringerLink
Log in

Influence of Jejunoileal and Common Limb Length on Weight Loss Following Roux-en-Y Gastric Bypass

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Capella surgery is one of the technical variations of Roux-en-Y gastric bypass. The method includes the preparation of an alimentary (Roux) limb with a standardized length (110 cm) in order to induce deficiencies in the absorption of macronutrients and thereby contribute to weight loss. The recognized variation in jejunoileal length in humans (approximately 4 to 9 m) is not considered, although this range correlates with the wide variation in the length of the common limb.

Methods

In order to assess the influence of variations in jejunoileal and common limb lengths on weight loss, intra-operative measurements were made of these segments on 100 patients undergoing Capella surgery. Patients were followed for a period of 1 year. Statistical analysis included subdivisions of the population by gender and body mass index.

Results

Average jejunoileal length was 671.4 ± 115.7 cm (434–990 cm). Average common limb length was 505.3 ± 113.3 cm (268–829 cm). No correlation was detected between jejunoileal length and weight loss at 6 months or 1 year following surgery. A weak negative correlation was detected between weight loss and common limb length at 1 year following surgery in male and super-obese patients.

Conclusions

Jejunoileal and common limb length vary widely in gastric bypass patients. To make modifications in the alimentary and/or biliopancreatic limb length, surgeons must consider the variability of the jejunoileal and common limb length.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.

    PubMed  Google Scholar 

  2. Capella RF, Capella JF, Mandac, et al. Vertical banded gastroplasty-gastric bypass: preliminary report. Obes Surg. 1991;1(4):389–95.

    Article  PubMed  Google Scholar 

  3. Capella JF, Capella RF. The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Am J Surg. 1996;171(1):74–9.

    Article  PubMed  CAS  Google Scholar 

  4. Bryant J. Observations upon the growth and length of the human intestine. Am J Med Sci. 1924;167:499–520.

    Article  Google Scholar 

  5. Hess DS. Limb measurements in duodenal switch. Obes Surg. 2003;13(6):966.

    Article  PubMed  Google Scholar 

  6. Underhill BML. Intestinal length in man. Br Med J. 1955;19;2(4950):1243–6.

    Article  Google Scholar 

  7. White S, Brooks E, Jurikova L, et al. Long-term outcomes after gastric bypass. Obes Surg. 2005;15(2):155–63.

    Article  PubMed  Google Scholar 

  8. Griffen WO Jr, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg. 1977;186(4):500–7.

    Article  PubMed  Google Scholar 

  9. Brolin RE. Long limb Roux en Y gastric bypass revisited. Surg Clin North Am. 2005;85(4):807–17.

    Article  PubMed  Google Scholar 

  10. Bruder SJ, Freeman JB, Brazeau-Gravelle P. Lengthening the Roux–Y limb increases weight loss after gastric bypass: a preliminary report. Obes Surg. 1991;1(1):73–7.

    Article  PubMed  Google Scholar 

  11. Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg. 2002;12(4):540–5.

    Article  PubMed  Google Scholar 

  12. Feng JJ, Gagner M, Pomp A, et al. Effect of standard vs extended Roux limb length on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2003;17(7):1055–60.

    Article  PubMed  CAS  Google Scholar 

  13. Fobi MAL, Lee H, Igwe Jr D, et al. Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Obes Surg. 2001;11(2):190–5.

    Article  PubMed  CAS  Google Scholar 

  14. Fox SR, Oh KH, Fox K. Vertical banded gastroplasty and distal gastric bypass as primary procedures: a comparison. Obes Surg. 1996;6(5):421–5.

    Article  PubMed  Google Scholar 

  15. Inabnet WB, Quinn T, Gagner M, et al. Laparoscopic Roux-en-Y gastric bypass in patients with BMI < 50: a prospective randomized trial comparing short and long limb lenghts. Obes Surg. 2005;15(1):51–7.

    Article  PubMed  Google Scholar 

  16. Freeman JB, Kotlarewsky M, Phoenix C. Weight loss after extended gastric bypass. Obes Surg. 1997;7(4):337–44.

    Article  PubMed  CAS  Google Scholar 

  17. Papadia F. Effect of standard vs extended Roux limb length on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2004;18(11):1683.

    PubMed  CAS  Google Scholar 

  18. Diniz MFHS, Passos VMA, Diniz MTC. Gut-brain communication: how does it stand after bariatric surgery? Curr Opin Clin Nutr Metab Care. 2006;9(5):629–36.

    Article  PubMed  Google Scholar 

  19. Rubino F, Gagner M, Gentileschi P, et al. The early effect of the Roux-en-Y gastric bypass on hormones involved in body weight regulation and glucose metabolism. Ann Surg. 2004;240(2):236–42.

    Article  PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Alexandre Lages Savassi-Rocha

    Present address: , Avenida Bernardo Monteiro 1397/802, Funcionários, Belo Horizonte, MG, 30150-281, Brazil

Authors and Affiliations

  1. Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Alexandre Lages Savassi-Rocha, Marco Túlio Costa Diniz, Paulo Roberto Savassi-Rocha, Jander Toledo Ferreira, Soraya Rodrigues de Almeida Sanches & Henrique Gomes de Barros

  2. Serviço de Endocrinologia e Metabologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Maria de Fátima Haueisen Sander Diniz

  3. Faculdade IBMEC, Belo Horizonte, Brazil

    Inara Kellen Fonseca

Authors
  1. Alexandre Lages Savassi-Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marco Túlio Costa Diniz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paulo Roberto Savassi-Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jander Toledo Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Soraya Rodrigues de Almeida Sanches
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria de Fátima Haueisen Sander Diniz
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Henrique Gomes de Barros
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Inara Kellen Fonseca
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexandre Lages Savassi-Rocha.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Savassi-Rocha, A.L., Diniz, M.T.C., Savassi-Rocha, P.R. et al. Influence of Jejunoileal and Common Limb Length on Weight Loss Following Roux-en-Y Gastric Bypass. OBES SURG 18, 1364–1368 (2008). https://doi.org/10.1007/s11695-008-9475-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-008-9475-1

Keywords

Search

Navigation