Effect of Long Biliopancreatic Limb RYGB on Weight Loss and Comorbidities

'Effect of Long biLiopancrEatic Limb lenGth in lAparoscopic Roux-eN-Y Gastric Bypass on Weight Loss and Comorbidities in Patients With Morbid obEsity: a Prospective Randomized Control Trial'

Morbid obesity is an increasing medical problem in the western countries. It's related to comorbidities as diabetes mellitus, hypertension, OSAS, arthrosis and hypercholesterolemia. The Roux-en-Y Gastric Bypass (RYGB) is an effective surgical therapy for morbidly obese patients. A part of these patients will have disappointing results, and have weight regain on the long term. Some studies show more weight reduction by increasing the biliopancreatic limb in patients with morbid obesity.

The objective of this study is to investigate the effect of variations in the length of biliopancreatic limb on weight reduction in morbidly obese patients undergoing RYGB-surgery. We hypothesize that longer biliopancreatic limb results in more weight reduction.

The study design is a prospective, randomized control trial. The patients will be randomized in 2 groups: a standard RYGB (short biliopancreatic limb) and long biliopancreatic limb RYGB.

Inclusion Criteria:

Patient eligible for bariatric surgery according Fried guidelines

Primary Gastric bypass

• BMI 35 - 40 with a comorbidity
• or BMI > 40

Redo- operation

• medical history: gastric sleeve/ mason / gastric band
• all BMI levels

Exclusion Criteria:

• Exclusion criteria for bariatric surgery (Fried Guidelines)
• Patients with language problems that interveins to follow medical advises
• Genetic diseases that intervens to follow medical advises
• Chronic bowel diseases
• Nephrologic (MDRD <30) of liver diseases (AST/ALT more than twice the norm)
• Pregnancy