Comparative nutritional, metabolic and body composition effect in patients of Roux-en-Y Gastric Bypass with Long or Short Pancreato-Biliary Limb

Abstract

Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most common techniques for the treatment of morbid obesity. However, evidence for the metabolic effects caused by the measures of intestinal limbs that are used in LRYGB is limited. The present study was conducted to assess the metabolic impact of using a long biliopancreatic limb (LBP-limb) versus a short biliopancreatic limb (SBP-limb) in patients with obesity undergoing LRYGB at six, nine and twelve months after the surgery to compare changes from baseline between the two procedures. Methods: Sixty-four patients with obesity participated in this study and underwent gastric bypass with either a 100-cm biliopancreatic limb (SBP-limb) and 150-cm alimentary limb (n = 31) or a 200-cm biliopancreatic limb (LBP-limb) and 50-cm alimentary limb (n = 33). Body weight, body fat (%), lean mass (%), total weight loss (%) and biochemical parameters glucose, glycosylated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, albumin and glycated hemoglobin were compared at the time of surgery and at six, nine and twelve months after surgery. Results: After surgery was observed in the LBP-limb group greater total weight loss (P = 0.004) at twelve months after surgery and a significant increase in HDL-C levels at six months (P = 0.001) compared with the SBP-limb group. However, no differences in the remission of comorbidities were found between the two groups. Conclusions: At the end of the first year after surgery the LBP-limb technique generated greater weight loss.