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Background <p>Roux-en-Y gastric bypass (RYGB) configurations vary, and recent evidence suggests that longer biliopancreatic limbs (BPL) may influence postoperative outcomes.</p> Objective <p>To assess whether a longer BPL in RYGB improves both weight loss and quality of life (QoL) over a two-year follow-up.</p> Methods <p>A multicenter, randomized controlled trial (RCT) comparing two groups: 150&#xa0;cm BPL/70&#xa0;cm Alimentary Limb (AL) vs. 70&#xa0;cm BPL/150&#xa0;cm AL. QoL was measured using the Bariatric Analysis and Reporting Outcome System (BAROS) score at 12 and 24 months.</p> Results <p>98 patients were included. The long-BPL group was associated with significantly higher total BAROS scores at both 12 and 24 months, with a clinically relevant moderate-to-large effect size at 24 months. A greater proportion of participants in the long-BPL group achieved “excellent” BAROS outcomes. Weight loss and remission of associated diseases were superior in the long-BPL group, while complication rates were comparable. The QoL subscore showed consistent advantages for this long-BPL group, particularly in self-esteem, physical activity, social interactions, and sexual well-being. Differences in total BAROS scores were primarily driven by greater weight loss and remission of related diseases. In the small subgroup without preoperative comorbidities, no significant differences were observed in exploratory analyses.</p> Conclusion <p>RYGB with a long BPL was associated with higher short- and mid-term composite outcomes, including greater weight loss and enhanced patient-reported QoL, compared with a shorter BPL configuration. Observed QoL differences appear related to weight-loss trajectories rather than an independent limb-length effect. Longer-term follow-up is ongoing to assess durability.</p> Graphical Abstracts <p></p>

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Quality of Life Two Years After Gastric Bypass with Long vs. Short Biliopancreatic Limb: Results from the Randomized BPG-1 Multicenter Trial

  • 期刊论文

  • 发表日期：

    2026年4月15日

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  • Débora Acín Gándara,
  • Juan José Arroyo Martín,
  • Manuel Medina García,
  • Fernando Pereira Pérez,
  • Esther Mans Muntwyler

摘要

Background

Roux-en-Y gastric bypass (RYGB) configurations vary, and recent evidence suggests that longer biliopancreatic limbs (BPL) may influence postoperative outcomes.

Objective

To assess whether a longer BPL in RYGB improves both weight loss and quality of life (QoL) over a two-year follow-up.

Methods

A multicenter, randomized controlled trial (RCT) comparing two groups: 150 cm BPL/70 cm Alimentary Limb (AL) vs. 70 cm BPL/150 cm AL. QoL was measured using the Bariatric Analysis and Reporting Outcome System (BAROS) score at 12 and 24 months.

Results

98 patients were included. The long-BPL group was associated with significantly higher total BAROS scores at both 12 and 24 months, with a clinically relevant moderate-to-large effect size at 24 months. A greater proportion of participants in the long-BPL group achieved “excellent” BAROS outcomes. Weight loss and remission of associated diseases were superior in the long-BPL group, while complication rates were comparable. The QoL subscore showed consistent advantages for this long-BPL group, particularly in self-esteem, physical activity, social interactions, and sexual well-being. Differences in total BAROS scores were primarily driven by greater weight loss and remission of related diseases. In the small subgroup without preoperative comorbidities, no significant differences were observed in exploratory analyses.

Conclusion

RYGB with a long BPL was associated with higher short- and mid-term composite outcomes, including greater weight loss and enhanced patient-reported QoL, compared with a shorter BPL configuration. Observed QoL differences appear related to weight-loss trajectories rather than an independent limb-length effect. Longer-term follow-up is ongoing to assess durability.

Graphical Abstracts