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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Primairy long biliopancreatic limb RYGB | Active Comparator | Roux limb 75 cm and Biliopancreatic Limb 150 cm |
|
| Redo Long biliopancreatic limb RYGB | Active Comparator | Roux limb 75 cm and Biliopancreatic limb 150 cm |
|
| Primairy standard RYGB | Active Comparator | Roux limb 150 cm and Biliopancreatic limb 75 cm |
|
| Redo standard RYGB | Active Comparator | Roux limb 150 cm and Biliopancreatic limb 75 cm |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Roux-en-Y Gastric Bypass | Procedure |
|
| Measure | Description | Time Frame |
|---|---|---|
| Weight reduction | excess weight loss (%EWL) | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Decrease in comorbidities | diabetes mellitus, hypertension, hypercholesterolemia, arthrosis | 2 years |
| Quality of life | SF-36 and BAROS |
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Inclusion Criteria:
Patient eligible for bariatric surgery according Fried guidelines
Primary Gastric bypass
Redo- operation
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| F.J. Berends, MD, PhD | Rijnstate Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rijnstate Hospital | Arnhem | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30073496 | Derived | Homan J, Boerboom A, Aarts E, Dogan K, van Laarhoven C, Janssen I, Berends F. A Longer Biliopancreatic Limb in Roux-en-Y Gastric Bypass Improves Weight Loss in the First Years After Surgery: Results of a Randomized Controlled Trial. Obes Surg. 2018 Dec;28(12):3744-3755. doi: 10.1007/s11695-018-3421-7. |
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| ID | Term |
|---|---|
| D009767 | Obesity, Morbid |
| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
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| ID | Term |
|---|---|
| D015390 | Gastric Bypass |
| ID | Term |
|---|---|
| D050110 | Bariatric Surgery |
| D049088 | Bariatrics |
| D000073319 | Obesity Management |
| D013812 | Therapeutics |
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| 2 years |
| Complications and re-operations | bleeding, wound infections, intra-abdominal abcess, anastomosis leakage, vitamine deficiencies | 2 years |
| D009750 |
| Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D005763 |
| Gastroenterostomy |
| D000714 | Anastomosis, Surgical |
| D013514 | Surgical Procedures, Operative |
| D013505 | Digestive System Surgical Procedures |