Impact of Biliopancreatic Limb Length (70 cm vs 120 cm), with Constant 150 cm Alimentary Limb, on Long-Term Weight Loss, Remission of Comorbidities and Supplementation Needs After Roux-En-Y Gastric Bypass: a Prospective Randomized Clinical Trial.

Abstract

The best alimentary and biliopancreatic limb (BPL) lengths in the Roux-en-Y gastric bypass (RYGB) still remain unclear. The aim of this study was to compare the effect of a BPL of 70 vs 120cm, with a constant AL of 150cm on long-term weight loss, remission of comorbidities, and supplementation needs after RYGB. A prospective randomized study of morbidly obese patients undergoing RYGB was performed. Patients were randomized into two groups: those patients undergoing RYGB with a BPL of 70cm (BPL 70cm) and those ones undergoing RYGB with a BPL of 120cm (BPL 120cm). BMI, excess BMI loss (EBMIL), remission of comorbidities and specific vitamin and mineral supplementation needs at 1, 2, and 5years were analyzed. Two hundred fifty-three patients were included in each group. There were no significant differences in BMI, EBMIL and the remission of diabetes mellitus, hypertension, and dyslipidemia between groups at 1, 2, and 5years after surgery. Patients from group BPL 120cm required greater specific supplementation of vitamin B12, folic acid, and vitamin A during all the follow-up. A RYGB with 120cm BPL does not achieve greater weight loss or remission of comorbidities than a RYGB with 70cm BPL but is associated with greater deficiencies of vitamin B12, vitamin A, and folic acid. ClinicalTrials.gov Identifier NCT03607305. https://clinicaltrials.gov/.