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Background <p>The study compared the outcomes of long biliopancreatic limb Roux-en-Y gastric bypass (GB) (LBP-RYGB), long Roux limb RYGB (LRL-RYGB), and one anastomosis gastric bypass (OAGB) regarding HbA1c level, glycemic control, and comorbidities improvement.</p> Methods <p>Retrospective analysis of 257 bypass surgeries (2015–2018) divided into three groups based on the surgical technique: LBP-RYGB (<i>n</i> = 47), LRL-RYGB (<i>n</i> = 58), and OAGB (<i>n</i> = 152). Preoperative, operative, and postoperative data were collected and analyzed.</p> Results <p>One-year weight loss was significantly higher in OAGB (40.45 ± 11.75 kg) as compared to LBP-RYGB (34.46 ± 14.07 kg) and LRL-RYGB (33.16 ± 10.86 kg), <i>P</i> = 0.002. One-year excessive body weight loss (EBWL) was 85.6% for LBP-RYGB, 79.9% for LRL-RYGB, and 90.4% for OAGB, <i>P</i> = .206. No significant differences were observed in final follow-up BMI (LBP-RYGB: 28.9 ± 4.36, LRL-RYGB: 29.6 ± 5.14, OAGB: 29.1 ± 3.61 kg/m<sup>2</sup>, <i>P</i> = 0.787) or %EBWL (77.08 ± 29.4, 73.78 ± 30.3, and 78.36 ± 23.2, respectively, <i>P</i> = 0.854).</p> <p>LBP-RYGB achieved lower 5-year HbA1c (5.3 ± 0.4) versus LRL-RYGB (5.8 ± 0.9) and OAGB (5.5 ± 0.6), <i>P</i> = 0.017. OAGB and LBP-RYGB showed better triglyceride reduction (− 22.5 ± 20 and − 21.5 ± 21) compared to LRL-RYGB (− 10.4), <i>P</i> = 0.003. LRL-RYGB had the longest operative time (139.8 ± 49.6&#xa0;min) and more marginal ulcers (3.4%). Internal hernia was higher in the LBP-RYGB and LRL-RYGB (8.5%) groups versus the OAGB group (0%), <i>P</i> = 0.001.</p> Conclusions <p>All three procedures effectively achieve weight loss and improve associated problems. However, OAGB had better 1-year weight loss, shorter operative time, and no internal hernia, making it an attractive option. RYGB should be reserved for reflux patients.</p>

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The Effect of Long Biliopancreatic Limb Versus Long Roux Versus Single Anastomosis Gastric Bypass: 5-Year Outcomes on HbA1c and Comorbidities

  • 期刊论文

  • 发表日期：

    2025年7月8日

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  • Harbi Khalayleh,
  • Izat Nazer,
  • Loai Omari,
  • George Asfour,
  • Rafael Miller,
  • Shimon Sapojnikov,
  • Abed Khalaileh,
  • Barak Bar-Zakai

摘要

Background

The study compared the outcomes of long biliopancreatic limb Roux-en-Y gastric bypass (GB) (LBP-RYGB), long Roux limb RYGB (LRL-RYGB), and one anastomosis gastric bypass (OAGB) regarding HbA1c level, glycemic control, and comorbidities improvement.

Methods

Retrospective analysis of 257 bypass surgeries (2015–2018) divided into three groups based on the surgical technique: LBP-RYGB (n = 47), LRL-RYGB (n = 58), and OAGB (n = 152). Preoperative, operative, and postoperative data were collected and analyzed.

Results

One-year weight loss was significantly higher in OAGB (40.45 ± 11.75 kg) as compared to LBP-RYGB (34.46 ± 14.07 kg) and LRL-RYGB (33.16 ± 10.86 kg), P = 0.002. One-year excessive body weight loss (EBWL) was 85.6% for LBP-RYGB, 79.9% for LRL-RYGB, and 90.4% for OAGB, P = .206. No significant differences were observed in final follow-up BMI (LBP-RYGB: 28.9 ± 4.36, LRL-RYGB: 29.6 ± 5.14, OAGB: 29.1 ± 3.61 kg/m2, P = 0.787) or %EBWL (77.08 ± 29.4, 73.78 ± 30.3, and 78.36 ± 23.2, respectively, P = 0.854).

LBP-RYGB achieved lower 5-year HbA1c (5.3 ± 0.4) versus LRL-RYGB (5.8 ± 0.9) and OAGB (5.5 ± 0.6), P = 0.017. OAGB and LBP-RYGB showed better triglyceride reduction (− 22.5 ± 20 and − 21.5 ± 21) compared to LRL-RYGB (− 10.4), P = 0.003. LRL-RYGB had the longest operative time (139.8 ± 49.6 min) and more marginal ulcers (3.4%). Internal hernia was higher in the LBP-RYGB and LRL-RYGB (8.5%) groups versus the OAGB group (0%), P = 0.001.

Conclusions

All three procedures effectively achieve weight loss and improve associated problems. However, OAGB had better 1-year weight loss, shorter operative time, and no internal hernia, making it an attractive option. RYGB should be reserved for reflux patients.