Long versus short biliopancreatic limb in Roux-en-Y gastric bypass: short-term results of a randomized clinical trial.

Abstract Background The Roux-en-Y gastric bypass continues to be one of the most performed bariatric surgeries, since an adequate balance between outcomes, complications and durability have been observed. Recently, the role of the biliopancreatic limb on weight loss and comorbidities control has gained attention, since it seems that has a positive impact based on the length. Objective To compare results at 12 months of a "standard" (group 1), versus a long (group 2) biliopancreatic limb-length bypass. Biliopancreatic limbs had 50 cm and 200 cm, and alimentary limbs 150 cm and 50 cm, respectively. Material and Methods Randomized study with patients undergoing both types of surgeries at a single academic center from 2016 to 2018. The analysis included weight loss, comorbidities control (diabetes and hypertension), biochemical panel, operative outcomes and complications. Results Two-hundred and ten patients were included (105 in each group). Almost every data was homogenous at baseline. Female sex comprised 86.1% of cases, with mean body mass index of 43.5 kg/m2. Excess weight loss (77.6 ± 15.7% vs. 83.6 ± 16.7%; p=0.011) and total weight loss (33.5 ± 6.4% vs. 37.1 ± 7.1%; p Conclusion The Roux-en-Y gastric bypass with 200 cm of biliopancreatic limb-length induces more weight loss at 12 months than a 50 cm limb-length. Better HbA1c level were also observed, but similar effects on comorbidities and complications.