Different limb lengths in gastric bypass surgery: study protocol for a Swiss multicenter randomized controlled trial...

Area of Science:

• Bariatric surgery
• Metabolic disease research
• Clinical trial design

Background:

• Obesity and type 2 diabetes mellitus (T2DM) are global health crises.
• Bariatric surgery, particularly Roux-Y-gastric bypass (RYGB), is effective for weight loss and comorbidity relief in morbidly obese patients.
• Variations in RYGB, such as altering the biliopancreatic limb (BPL) length, are being explored to optimize outcomes.

Purpose of the Study:

• To compare the effectiveness and safety of RYGB with a long BPL versus a short BPL.
• To determine if a longer BPL leads to greater weight loss and T2DM resolution.
• To provide Level I evidence for potential improvements to standard RYGB procedures.

Main Methods:

• A multicenter, randomized, patient- and observer-blinded superiority trial.
• Eight hundred patients (BMI 35-60 kg/m²) aged 18-65 will be randomized to either long or short BPL RYGB.
• Primary endpoints include percent total weight loss and nutritional deficiency rate; secondary endpoints include morbidity, mortality, comorbidity remission, and quality of life over 5 years.

Main Results:

• Study is ongoing; results not yet available.

Conclusions:

• This trial aims to provide high-level evidence on the efficacy and safety of long BPL RYGB.
• Findings may influence future bariatric surgery guidelines globally.
• The 5-year follow-up will offer comprehensive data on long-term outcomes.