Mid-term Outcomes in Primary Roux-en-Y Gastric Bypass Procedures with Short or Long Biliopancreatic Limb

Area of Science:

• Bariatric Surgery
• Metabolic Surgery
• Obesity Management

Background:

• Roux-en-Y gastric bypass (RYGB) is a common bariatric procedure.
• The length of the biliopancreatic limb (BPL) may influence outcomes.
• Mid-term results comparing short (60 cm) versus long (150 cm) BPL in RYGB for obesity and type 2 diabetes (T2D) are reported.

Purpose of the Study:

• To compare the efficacy of long BPL RYGB versus short BPL RYGB.
• To assess differences in weight loss, T2D remission, HbA1c levels, and nutritional deficiencies.

Main Methods:

• Retrospective comparison of 165 patients undergoing RYGB between 2016-2021.
• Propensity score matching was used to compare long BPL (150 cm) and short BPL (60 cm) groups.
• Outcomes assessed included T2D remission, HbA1c, weight loss (%TWL), and nutritional status.

Main Results:

• Weight loss was initially accelerated with long BPL RYGB but similar at 2 years.
• Complete T2D remission rates were comparable (53.3% long BPL vs. 61.3% short BPL).
• Long BPL RYGB demonstrated a significantly greater HbA1c reduction (1.5% vs. 0.72%) after 2 years. Higher zinc deficiency was noted in the long BPL group.

Conclusions:

• Long BPL RYGB is a safe procedure for obesity and T2D.
• It leads to accelerated initial weight loss and superior HbA1c reduction at 2 years.
• Overall morbidity is low, with zinc deficiency being a potential concern.