Shorter Vs. Longer Biliopancreatic Limbs in One-Anastomosis Gastric Bypass: A Comparative Study of Weight Loss and Nutritional Outcomes Publisher Pubmed



Sayadi M ; Dehkordi MM ; Kelidari B ; Sheikhbahaei E ; Zare MM ; Saneie MA
Source: Langenbeck's Archives of Surgery Published:2025

Abstract

Background: One anastomosis gastric bypass (OAGB) is safe and effective treatment for patients with severe obesity. OAGB with a biliopancreatic limb (BPL) of 200–250 cm often leads to metabolic and nutritional issues, which may be mitigated by using a shorter biliopancreatic limb (BPL) length (170–180 cm). However, the impact of shorter BPL lengths on efficacy remains uncertain. Methods: A retrospective cohort study was conducted on patients who underwent OAGB at two Iranian centers between March 2018 and March 2021. Patients were divided into two groups based on BPL length: 170–180 cm and 200–250 cm. Groups were compared for weight loss, nutritional status, and comorbidity resolution over two years. Results: Both groups achieved comparable weight loss (BMI reduction: 28.4 vs. 28.3 kg/m², p = 0.913), with complete hypertension resolution observed in 95.6%of hypertensive patients and complete diabetes remission in 90% of diabetic patients. Nutritional outcomes were comparable between groups (albumin, vitamin D, B12), though ferritin levels were numerically lower in the 200–250 cm group. Despite concerns about malnutrition following OAGB, our findings demonstrate that a 170–180 cm BPL achieves weight loss and comorbidity resolution comparable to a 200–250 cm BPL, with reduced nutritional risks. Conclusion: OAGB with a 170–180 cm BPL yields weight loss and comorbidity resolution comparable to a 200–250 cm BPL, with potentially fewer nutritional deficiencies. © 2025 Elsevier B.V., All rights reserved.