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Biliopancreatic Limb Length in One Anastomosis Gastric Bypass: Which Is the Best?

Authors :
Ludovico Docimo
Francesco Pizza
Francesco Saverio Lucido
Alberto Marvaso
Salvatore Tolone
Claudio Gambardella
Chiara Dell’Isola
Dario D’Antonio
Pizza, Francesco
Lucido, Francesco Saverio
D'Antonio, Dario
Tolone, Salvatore
Gambardella, Claudio
Dell'Isola, Chiara
Docimo, Ludovico
Marvaso, Alberto
Source :
Obesity Surgery. 30:3685-3694
Publication Year :
2020
Publisher :
Springer Science and Business Media LLC, 2020.

Abstract

The use of one anastomosis gastric bypass (OAGB) is rapidly spreading. Concerns about biliary reflux and malabsorption with consequent nutritional deficits exist, so studies on biliopancreatic limb (BPL) adequate length in OAGB are required to balance excess weight loss in percentage (% EWL), resolution of comorbidities, and nutritional deficit. The purpose was to evaluate, at 2 years after OAGB, the effects of BPL length on weight loss, resolution of comorbidity, and nutritional deficiencies in patients. From January 2015 to January 2017, 180 patients were collected into three groups based BPL length: group A, 150 cm; group B, 180 cm; and group C, 200 cm. Aims were to compare %EWL, co-morbidity resolution rates, nutritional parameters, and morbidity/mortality in the three groups. The total number of patients was 180: 60 for each group. One hundred seventy-two (95%) patients attended the 1-year follow-up (group A = 58; group B = 58, group C = 56). One hundred fifty-seven (87%) patients attended the 2-year follow-up (group A = 52 (87%); group B = 53 (88%); group C = 52 (87%)). There was no statistically significant difference in %EWL, %TWL, T2DM, and hypertension resolution rates among the groups. About vitamin deficiency, differences were not statistically significant. Iron and ferritin deficiency rate were statistically significant only between A and C groups. According to our evidence, standardization of BPL length shorter than 200 cm is suggested, potentially minimizing malnutrition-related outcomes. Our study seems to show that a BPL of 150–180 cm is safe and effective in terms of EWL and comorbidity improvement with low malnutrition effects even in BMI > 50.

Details

ISSN :
17080428 and 09608923
Volume :
30
Database :
OpenAIRE
Journal :
Obesity Surgery
Accession number :
edsair.doi.dedup.....410a64a89d8ebe93ece13c3aff8b7ec0
Full Text :
https://doi.org/10.1007/s11695-020-04687-x