Laparoscopic Roux-en-Y Gastric Bypass

Berbiglia, Lindsay; Zografakis, John G.; Dan, Adrian G.

doi:10.1016/j.suc.2016.03.003

Cited by 31 publications

(6 citation statements)

References 110 publications

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“…A GE is constructed by approximation of the distal tip of the transected jejunum to the small gastric pouch, which is then anastomosed together, again typically using linear stapling devices. The Roux-en-Y reconstruction is completed by the creation of an entero-enteroanastomosis (EEA) between the proximal, or biliary, end of the transected jejunum and the Roux-limb, typically about 100 cm distal to the GE [6]. There are numerous variations in the basic LRYGB technique described above, for example, the Roux-limb can be brought to the gastric pouch in both an antecolic and retrocolic fashion, the GE can be constructed with a circular stapler, or even completely hand-sewn.…”

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confidence: 99%

Laparoscopic Roux-en-Y Gastric Bypass Without Division of the Mesentery Reduces the Risk of Postoperative Complications

et al. 2018

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Background Anastomotic complications after laparoscopic Roux-en-Y gastric bypass (LRYGB) including leaks, ulceration, and stenosis remain a significant cause of post-operative morbidity and mortality. Our objective was to compare two different surgical techniques regarding short-term anastomotic complications. Methods A retrospective analysis of all patients operated with a primary LRYGB from 2006 to June 2015 in one institution, where prospectively collected data from an internal quality registry and medical journals were analyzed. Results In total, 2420 patients were included in the analysis. 1016 were operated with a technique where the mesentery was divided during the creation of the Roux-limb (DM-LRYGB) and 1404 were operated with a method where the mesentery was left intact (IM-LRYGB). Leakage in the first 30 days [2.6% vs. 1.1% ( p < 0.05)], and ulceration or stenosis occurring during the first 6 months after surgery [5.6% vs. 0.1% ( p < 0.05)] was significantly higher in the DM-LRYGB group. Adjusted odds ratio for anastomotic leak was 0.46 (95% CI 0.24–0.87) and for stenosis/ulceration 0.01 (95% CI 0.002–0.09). Conclusion IM-LRYGB seems to reduce the risk of complications at the anastomosis. A plausible explanation for this is that the blood supply to the anastomosis is compromised when the mesentery is divided.

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confidence: 99%

Laparoscopic Roux-en-Y Gastric Bypass Without Division of the Mesentery Reduces the Risk of Postoperative Complications

et al. 2018

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“…Following national criteria [ 22 ], patients over 18 years of age were deemed eligible for surgery in case of a BMI ≥ 35 kg/m 2 and an ineffective attempt of a nonoperative weight loss intervention over a period of 2 years. All RYGB surgeries (RYGBs) were performed laparoscopically according to international standards [ 2 ] in a single bariatric surgery center with two local sites. All procedures were performed by two surgeons, except 15% of the LBPL-RYGBs, which were performed by a trainee under supervision of one of the other two surgeons in exactly the same manner.…”

Section: Methodsmentioning

confidence: 99%

Effects of short or long biliopancreatic limb length after laparoscopic Roux-en-Y gastric bypass surgery for obesity: a propensity score-matched analysis

Gass

2022

Langenbecks Arch Surg

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Purpose Although recent studies reported superior weight reduction in patients undergoing Roux-en-Y gastric bypass (RYGB) with long biliopancreatic limb (BPL), no recommendation regarding limb lengths exists. This study compares weight loss and resolution of obesity-related comorbidities in patients undergoing RYGB with either long or short BPL. Methods A retrospective data search from medical records was performed. A total of 308 patients underwent laparoscopic RYGB with a BPL length of either 100 cm or 50 cm. Data was analyzed before and after propensity score matching. Results No statistically significant difference in weight reduction between long and short BPL RYGB in terms of percentage of excess weight loss (%EWL) (86.4 ± 24.5 vs. 83.4 ± 21.4, p = 0.285) and percentage of total weight loss (%TWL) (32.4 ± 8.4 vs. 33.0 ± 8.3, p = 0.543) was found 24 months after surgery. Propensity score–matched analysis did not show any statistically significant difference between groups in both %EWL and %TWL. No significant difference between long and short BPL RYGB in the resolution of obesity-related comorbidities was noted 24 months after surgery. Conclusion Weight loss and resolution of obesity-related comorbidities were not significantly different between long and short BPL RYGB 24 months after surgery.

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“…All procedures were completed laparoscopically by a senior chief physician, Dr Nengwei Zhang, an experienced doctor in bariatric surgery and followed standard procedures. [11]…”

Section: Methodsmentioning

confidence: 99%

Long-limb length difference had no effect on outcomes of laparoscopic Roux-en-Y gastric bypass surgery for obese Chinese patients with type 2 diabetes mellitus

Yan

Sun²,

Lian³

et al. 2018

Medicine

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Bariatric surgery is effective in treating different components of metabolic syndrome including obesity, type 2 diabetes mellitus (T2DM), and hyperlipidemia. But there is no consensus on the ideal biliopancreatic and Roux limb length. This study aimed to explore the effect of biliopancreatic limb and Roux limb lengths during laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures on weight loss and T2DM control.We studied the clinical records of 58 patients with metabolic syndrome, T2DM, and body mass index (BMI) 32 to 50 kg/m who underwent LRYGB in our hospital. The short limb group (Group A) underwent LRYGB with a limb length of 160 to 200 cm (n = 31) and the long limb group (Group B) underwent LRYGB with a limb length of 210 to 240 cm (n = 27) were compared.The occurrence of acute or chronic internal hernia in Group B was higher than that in Group A (P = .026). Twelve months after surgery, patients from the 2 groups were also observed with reduction in BMI, percent excess weight loss (EWL), preoperative FPG, and HbA1c as compared with these indicators before surgery. However, the differences of these indicators between 2 groups were not significant at the time point of before and 3, 6, 12 months after surgery.LRYGB had significant effects on weight loss and diabetes control in obese T2DM patients. However, there was no significant difference in the short term on weight loss and diabetes control in the patients receiving different limb lengths.

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Laparoscopic Roux-en-Y Gastric Bypass

Cited by 31 publications

References 110 publications

Laparoscopic Roux-en-Y Gastric Bypass Without Division of the Mesentery Reduces the Risk of Postoperative Complications

Laparoscopic Roux-en-Y Gastric Bypass Without Division of the Mesentery Reduces the Risk of Postoperative Complications

Effects of short or long biliopancreatic limb length after laparoscopic Roux-en-Y gastric bypass surgery for obesity: a propensity score-matched analysis

Long-limb length difference had no effect on outcomes of laparoscopic Roux-en-Y gastric bypass surgery for obese Chinese patients with type 2 diabetes mellitus

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