Long versus short biliopancreatic limb in Roux-en-Y gastric bypass: short-term results of a randomized clinical trial

Zerrweck, Carlos; Herrera, Antonio; Sepúlveda, Elisa; Rodriguez, Fatima; Guilbert, Laure

doi:10.1016/j.soard.2021.03.030

Cited by 19 publications

(5 citation statements)

References 27 publications

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“…These results demonstrate and confirm that both surgeries have an excellent impact on losing excess weight, specifically in the first year after surgery, where the adaptations to the new gastrointestinal anatomy are more noticeable. [10][11][12][13] The results in the LBPL-GB group regarding the suspension of medications for T2D were significantly better, despite not being so clearly manifested in weight loss or excess weight lost. Similarly, the suspension of medications for hypertension was higher in the LBPL-GB group compared to the S-GB group, which matches with previously published studies.…”

Section: Discussionmentioning

confidence: 92%

Short-term outcomes after long inverted versus short standard biliopancreatic limb in Roux-en-Y gastric bypass

Vela¹,

Ibarrola²,

Lopez³

et al. 2022

Int J Res Med Sci

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Background: Obesity is a public health issue that affects the entire world and it is rising. Roux-en-Y gastric bypass is one of the most common bariatric procedures and it can reach a significant and sustained excess weight loss and efficient comorbidity control. The main objective was to compare short-term outcomes between standard versus long biliopancreatic limb gastric bypass patients.Methods: it was a retrospective, comparative, descriptive, single-center study. We evaluated obese patients that underwent a laparoscopic Roux-en-Y gastric bypass with standard or long biliopancreatic limb in Centro Medico ABC, Mexico City, and compared general demographics, weight loss, excess weight loss, comorbidities and quality of life.Results: Of 50 patients analyzed, 24 were in the standard gastric bypass (S-GB) and 26 in the long biliopancreatic limb (LBPL-GB). Mean weight loss in the S-GB group was 33.1±12.1 kg and in the LBPL-GB was 40.2±12.6 kg with a difference of 7.1 kg. The percentage of excess weight loss (%EWL) was 72.5±14% in S-GB and 72.9±19% in LBPL-GB, with a difference of 0.4% in the 12 months of follow-up. There was a complete reduction of hypoglycemic drugs in 80% in the S-GB group and 100% in the LBPL-GB group.Conclusions: With this modification of the technique, we achieved important outcomes in regard of comorbidities, without affecting drastically weight loss or the EWL. This procedure is safe and feasible.

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Section: Discussionmentioning

confidence: 92%

Short-term outcomes after long inverted versus short standard biliopancreatic limb in Roux-en-Y gastric bypass

Vela¹,

Ibarrola²,

Lopez³

et al. 2022

Int J Res Med Sci

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“…Carswell et al used sulphapyridine, a marker of oro-caecal transit time, with no change demonstrated [28]. A second significant confounder is the non-standardized size of the gastric tube in SG, and variation in alimentary/biliary limb length in RYGB/DS [70][71][72][73].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Permeability After Bariatric Surgery: A Systematic Review

O'Brien,

Merali,

Pring

et al. 2024

Cureus

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Gastrointestinal permeability refers to the movement of substances across the gut wall. This is mediated by endotoxemia (bacterial products entering the systemic circulation), and is associated with metabolic disease. The effect of bariatric surgery on permeability remains uncertain; the associated dietary, metabolic and weight changes are suggested to influence, or trigger, altered permeability. The primary aim of this study is to synthesize evidence and analyze the effect of bariatric surgery on permeability. A systematic review was performed, searching MEDLINE, EMBASE, and Scopus until February 2023, using MESH terms “intestinal permeability”, “bariatric”, for studies reporting in vivo assessment of permeability. Three cohort studies and two case series were identified (n=96). Data was heterogeneous; methodology and controls preclude meta-analysis. Gastroduodenal permeability reduced post-sleeve gastrectomy (SG). Two studies showed an increase in small intestinal permeability after biliopancreatic diversion. Two studies revealed a decrease in post-Roux-en-Y gastric bypass. One study identified increased colonic permeability six months post-SG. Evidence regarding permeability change after bariatric surgery is conflicting, notably for the small intestine. Impaired colonic permeability post-SG raises concerns regarding colonic protein fermentation and harmful dietary sequelae. There are multiple interacting variables confounding gastrointestinal permeability change; procedure type, altered microbiota and metabolic response to surgery. Further understanding of this important aspect of obesity is required, both before and after bariatric surgery.

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“…However, most participants preferred a 50–100 cm alimentary limb for these patients, instead of the 150-cm alimentary limb of the usually performed RYGB. It has been shown that a longer biliopancreatic limb leads to more weight loss after RYGB [ 49 , 50 ] especially in mid-term follow-ups [ 51 ]. Responses are also surprising regarding gastric pouch volume and gastrojejunostomy size.…”

Section: Discussionmentioning

confidence: 99%

Bariatric and metabolic surgery in patients with low body mass index: an online survey of 543 bariatric and metabolic surgeons

Shahmiri,

Parmar,

Yang

et al. 2023

BMC Surg

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Background Metabolic and bariatric surgery (MBS) in patients with low body mass index patients is a topic of debate. This study aimed to address all aspects of controversies in these patients by using a worldwide survey. Methods An online 35-item questionnaire survey based on existing controversies surrounding MBS in class 1 obesity was created by 17 bariatric surgeons from 10 different countries. Responses were collected and analysed by authors. Results A total of 543 bariatric surgeons from 65 countries participated in this survey. 52.29% of participants agreed with the statement that MBS should be offered to class-1 obese patients without any obesity related comorbidities. Most of the respondents (68.43%) believed that MBS surgery should not be offered to patients under the age of 18 with class I obesity. 81.01% of respondents agreed with the statement that surgical interventions should be considered after failure of non-surgical treatments. Conclusion This survey demonstrated worldwide variations in metabolic/bariatric surgery in patients with class 1 obesity. Precise analysis of these results is useful for identifying different aspects for future research and consensus building.

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Long versus short biliopancreatic limb in Roux-en-Y gastric bypass: short-term results of a randomized clinical trial

Cited by 19 publications

References 27 publications

Short-term outcomes after long inverted versus short standard biliopancreatic limb in Roux-en-Y gastric bypass

Short-term outcomes after long inverted versus short standard biliopancreatic limb in Roux-en-Y gastric bypass

Gastrointestinal Permeability After Bariatric Surgery: A Systematic Review

Bariatric and metabolic surgery in patients with low body mass index: an online survey of 543 bariatric and metabolic surgeons

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