Small Bowel Limb Lengths and Roux-en-Y Gastric Bypass: a Systematic Review

Mahawar, Kamal; Kumar, Parveen; Parmar, Chetan; Graham, Yitka; Carr, William; Jennings, Neil; Schroeder, Norbert; Balupuri, S.; Small, Peter

doi:10.1007/s11695-016-2050-2

Cited by 131 publications

(66 citation statements)

References 54 publications

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“…e other issue about bariatric surgery is the intestinal bypassed length that causes fewer complications such as malabsorption and also acceptable weight loss. Studies have recommended different formulas for that [12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted by Mahawar et al, they presented that a bypass length of 100-200 cm has acceptable outcomes and few possible complications such as malabsorption [16], while in a study conducted by Carbajo et al, they assessed patients who had undergone MGB/OAGB with 250-300 cm bypass length and found malabsorption in 1.1% of them that was compatible with prevalence of protein malabsorption presented in other studies [14]. In a study conducted by Lee et al, they compared outcomes of MBG/OAGB surgery in which bypassed length was chosen based on patients' BMI.…”

Section: Discussionmentioning

confidence: 99%

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The Early Results of the Laparoscopic Mini-Gastric Bypass/One Anastomosis Gastric Bypass on Patients with Different Body Mass Index

et al. 2020

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Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. is study has aimed to assess shortterm metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40-45 and 45-50 kilograms per square meter (kg/m 2 ). Methods. 25 patients were put in group 1 (BMI � 40-45 kg/m 2 ) and 25 patients in group 2 (BMI � 45-50 kg/m 2 ). Patients' BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3-and 6-month follow-up. Results. Weight loss and BMI reduction was significantly more in patients with higher BMI level (P � 0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P � 0.007). Six-month follow-up showed statistically significant reduction in total cholesterol, total triglyceride, Fe, and vitamin B12 among patients with higher BMI level (P value <0.05). Conclusion. Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40-45 and 45-50 kg/m 2 , according to their significant decrease in weight, BMI, and improving glycolipid profile.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Early Results of the Laparoscopic Mini-Gastric Bypass/One Anastomosis Gastric Bypass on Patients with Different Body Mass Index

et al. 2020

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“…In the most commonly performed technique, the proximal RYGB, only the lengths of the alimentary (AL) and the biliopancreatic limbs (BPL) are defined and counted through, whereas the common channel remains of variable, unknown size. While AL of 100-150 cm and BPL of 45-85 cm are commonly used[30,34,35], there is ongoing debate about the delineation of optimal limb lengths. Nonetheless, this debate does not respect absorptive capacity of small bowel and even less its adaptation over time.…”

Section: Short Bowel Syndromementioning

confidence: 99%

Diarrhea after bariatric procedures: Diagnosis and therapy

Borbély¹,

Osterwalder²,

Kröll³

et al. 2017

WJG

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Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future. A multitude of factors exert their influence on bowel habits; preoperative comorbidities and procedure-related aspects are intertwined with postoperative nutritional habits. Diagnosis may be challenging owing to the characteristics of post-bariatric surgery anatomy with hindered accessibility of excluded segments of the small bowel and restriction at the gastric level. Conventional testing measures, if available, generally yield low accuracy and are usually not validated in this specific population. Limited trials of empiric treatment are a practical alternative and oftentimes an indispensable part of the diagnostic process. This review provides an overview of causes for chronic post-bariatric surgery diarrhea and details the particularities of its diagnosis and treatment in this specific patient population. Topics of current interest such as the impact of gut microbiota and the influence of bile acids on morbid obesity and especially their role in diarrhea are highlighted in order to provide a better understanding of the specific problems and chances of future treatment in post-bariatric surgery patients.

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“…[6] There are variations between the constructed limb lengths of RYGBPs described in the literature, and these are designed by the surgeon's preference. [7,8] Most surgeons create a restricted gastric pouch from which the alimentary limb (AL) (100-150 cm) follows to join the biliopancreatic limb (BPL) (usually 50-100 cm in length) to form the common limb. The remaining common limb (CL) length is of an indeterminate currently unknown is whether there is an impact of the total/bypassed bowel length on the incidence of complications and failure.…”

Section: Wwwmisjournalnetmentioning

confidence: 99%