Chetna Bakshi, MD1, Julio Teixeira, MD2. 1Zucker School of Medicine at Hofstra/Northwell, 2Lenox Hill Hospital, Northwell Health
Background: Roux-en-y gastric bypass promotes weight loss by restrictive and malabsorptive means. The malabsorptive effects are due to bypassing a portion of jejunum as well as hormonal pathways that are not fully understood1. There is variation in the lengths of the biliopancreatic limb (BPL) and alimentary limb (AL) lengths among different centers. Whereas some studies have shown increased weight loss with increased BPL and AL lengths2, others have shown no difference3. The aim of our study was to compare weight loss with a BPL length of 100cm versus 150cm, and a stable AL (100cm).
Methods: Single center retrospective review of 50 patients, 25 patients with a BPL length of 100cm (group 1) versus 25 with a BPL length of 150cm (group 2), between 2015-2016 at our Bariatric Center of Excellence. Weights were measured preoperatively and at varying times of follow up from 20 days to over 2 years.
Results: We calculated and compared the average decrease in weight change from surgery to follow-up weigh-in between the two groups. There was no significant difference in average weight decrease between the groups; group 1 vs 2 [27.69kg s+/- 14.79kg vs 28.87kg +/- 13.77kg, p=0.77]. There was also no significant difference in average days to follow up weigh-in between group 1 vs group 2 [285.28 days vs 281.32 days, p=0.93].
Conclusions: It is theorized that a longer BPL length provides more malabsorption, and therefore should provide greater weight loss. However, in our study, no weight loss difference was seen in patients with a BPL length of 100cm versus 150cm, with a stable AL of 100cm. Even after controlling for differences in surgical technique between surgeons and different centers, no added advantage to lengthening the BPL was seen in terms of weight loss. Further research is needed to determine other effects of lengthening the BPL, such as effects on comorbidities, hormonal changes, and deleterious effects.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94002
Program Number: P150
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster