Jaime Ruiz-Tovar1, Miguel A Carbajo2, Jose M Jimenez3, Enrique Luque-de-Leon2, Javier Ortiz-de-Solorzano2, Maria J Castro2. 1. Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Calle Estacion, No. 12, 1°, 47004, Valladolid, Spain. jruiztovar@gmail.com. 2. Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Calle Estacion, No. 12, 1°, 47004, Valladolid, Spain. 3. Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Calle Estacion, No. 12, 1°, 47004, Valladolid, Spain. jsmrjimenez@gmail.com.
Abstract
BACKGROUND: Ideal jejunal and ileal lengths in bariatric/metabolic procedures to be left in alimentary continuity still remain unclear. We aimed to evaluate different lengths of biliopancreatic limb (BPL) and common limb (CL) performed in a series of patients submitted to OAGB, and correlate them with weight loss and nutritional deficits. PATIENTS AND METHODS: A prospective observational study of 350 consecutive morbidly obese patients undergoing OAGB was performed. BPL and CL lengths were determined intraoperatively; BPL/TBL and CL/TBL ratios were then calculated. Anthropometric variables, remission of comorbidities and specific supplementation needs were recorded at 1, 2 and 5 years after surgery. RESULTS: Three hundred patients were included for final analysis. BPL length and BPL/TBL ratio directly correlated with Units of BMI lost (UBMIL). Conversely, CL length and CL/TBL ratio showed an inverse correlation with UBMIL. Establishing a BMI ≤ 25 kg/m2 as ideal, the most accurate AUC, to predict achieving an ideal BMI at 1, 2 and 5 years after surgery, was obtained for the CL/TBL ratio, followed by the CL length at 1, 2 and 5 years. An ideal range was established between 0.40 and 0.43 for the CL/TBL ratio, and 200 to 220 cm for the CL length. Among these ranges, there were no cases of protein or calorie malnutrition. CONCLUSION: TBL measurement is essential to obtain optimal outcomes after OAGB, both in terms of excellent weight loss and remission/improvement of comorbidities, as well as with a low risk of nutritional deficiencies. The CL/TBL ratio, followed by CL length, are the most accurate parameters to predict a 5-year postoperative BMI ≤ 25 kg/m2.
BACKGROUND: Ideal jejunal and ileal lengths in bariatric/metabolic procedures to be left in alimentary continuity still remain unclear. We aimed to evaluate different lengths of biliopancreatic limb (BPL) and common limb (CL) performed in a series of patients submitted to OAGB, and correlate them with weight loss and nutritional deficits. PATIENTS AND METHODS: A prospective observational study of 350 consecutive morbidly obesepatients undergoing OAGB was performed. BPL and CL lengths were determined intraoperatively; BPL/TBL and CL/TBL ratios were then calculated. Anthropometric variables, remission of comorbidities and specific supplementation needs were recorded at 1, 2 and 5 years after surgery. RESULTS: Three hundred patients were included for final analysis. BPL length and BPL/TBL ratio directly correlated with Units of BMI lost (UBMIL). Conversely, CL length and CL/TBL ratio showed an inverse correlation with UBMIL. Establishing a BMI ≤ 25 kg/m2 as ideal, the most accurate AUC, to predict achieving an ideal BMI at 1, 2 and 5 years after surgery, was obtained for the CL/TBL ratio, followed by the CL length at 1, 2 and 5 years. An ideal range was established between 0.40 and 0.43 for the CL/TBL ratio, and 200 to 220 cm for the CL length. Among these ranges, there were no cases of protein or calorie malnutrition. CONCLUSION: TBL measurement is essential to obtain optimal outcomes after OAGB, both in terms of excellent weight loss and remission/improvement of comorbidities, as well as with a low risk of nutritional deficiencies. The CL/TBL ratio, followed by CL length, are the most accurate parameters to predict a 5-year postoperative BMI ≤ 25 kg/m2.
Authors: M A Carbajo; Maria J Castro; S Kleinfinger; S Gómez-Arenas; J Ortiz-Solórzano; R Wellman; C García-Ianza; E Luque Journal: Nutr Hosp Date: 2010 Nov-Dec Impact factor: 1.057
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Authors: Miguel A Carbajo; Enrique Luque-de-León; José M Jiménez; Javier Ortiz-de-Solórzano; Manuel Pérez-Miranda; María J Castro-Alija Journal: Obes Surg Date: 2017-05 Impact factor: 4.129
Authors: Mohammad Kermansaravi; Amir Hossein DavarpanahJazi; Shahab ShahabiShahmiri; Miguel Carbajo; Antonio Vitiello; Chetan D Parmar; Mario Musella Journal: Obes Surg Date: 2021-02-17 Impact factor: 4.129
Authors: Mario Musella; Antonio Vitiello; Antonio Susa; Francesco Greco; Maurizio De Luca; Emilio Manno; Stefano Olmi; Marco Raffaelli; Marcello Lucchese; Sergio Carandina; Mirto Foletto; Francesco Pizza; Ugo Bardi; Giuseppe Navarra; Angelo Michele Schettino; Paolo Gentileschi; Giuliano Sarro; Sonja Chiappetta; Andrea Tirone; Giovanna Berardi; Nunzio Velotti; Diego Foschi; Marco Zappa; Luigi Piazza Journal: Obes Surg Date: 2022-01-01 Impact factor: 4.129