From the Guidelines
The length of the BP limb in a RNYGB surgery is typically not directly stated, but for similar procedures like OAGB/MGB, a BP limb length of 150 cm or less is recommended to follow RYGB nutritional recommendations. In the context of RNYGB surgery, the BP limb length is crucial for determining the extent of malabsorption and potential weight loss outcomes.
- The BP limb is the portion of the small intestine that carries digestive juices from the liver and pancreas but is bypassed for food transit.
- The length of this limb affects nutrient absorption and weight loss outcomes.
- According to the British Obesity and Metabolic Surgery Society guidelines 1, for procedures like OAGB/MGB with a BP limb length of 150 cm or less, the nutritional recommendations are similar to those for RYGB.
- However, it's essential to note that the specific length of the BP limb in RNYGB surgery may vary based on patient characteristics, such as BMI, comorbidities, and weight loss goals.
- A study published in Obesity Reviews 1 provides guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery, but does not directly specify the length of the BP limb for RNYGB.
- In general, the length of the BP limb is determined by the surgeon based on the patient's individual needs, and patients will require lifelong vitamin and mineral supplementation regardless of limb length to prevent deficiencies.
From the Research
Biliopancreatic Limb Lengths in RYGB Surgery
The lengths of the biliopancreatic limb in Roux-en-Y gastric bypass (RYGB) surgery can vary. According to the studies, the following lengths have been used:
Comparison of Biliopancreatic Limb Lengths
Studies have compared the effects of different biliopancreatic limb lengths on weight loss and comorbidity control:
- A study found that a longer biliopancreatic limb (100 cm) resulted in faster weight loss and better control of diabetes and dyslipidemia compared to a shorter limb (50 cm) 2
- Another study found that a biliopancreatic limb of 120 cm did not achieve greater weight loss or remission of comorbidities compared to a limb of 70 cm, but was associated with greater deficiencies of vitamin B12, vitamin A, and folic acid 4
- A randomized clinical trial found that a longer biliopancreatic limb (200 cm) resulted in more weight loss at 12 months compared to a shorter limb (50 cm) 3
- A retrospective analysis found that a longer biliopancreatic limb (150 cm) was associated with more excess weight loss and total weight loss, but also with more diarrhea and steatorrhea 5