Department of Surgery, Division of Minimally Invasive Bariatric and General Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Surgery. 2019 Oct;166(4):445-455. doi: 10.1016/j.surg.2019.05.046. Epub 2019 Aug 1.
Some studies suggest that changes in weight or metabolic outcomes are affected by the lengths of the gastrointestinal limbs in the Roux-en-Y gastric bypass.
Participants (N = 1,770) underwent primary Roux-en-Y gastric bypass and were followed ≤7 years in the Longitudinal Assessment of Bariatric Surgery-2, a multicenter US cohort study. Alimentary limb and biliopancreatic limb lengths were measured according to research protocol; common channel was measured in a subsample (N = 547). Aimentary limb, biliopancreatic limb, and common channel ratio to total small bowel length were calculated.
Median presurgery body mass index was 46 (25th-75th percentile: 43-51) kg/m. Medians (25th-75th percentiles) for alimentary limb length were 125 cm (100-150), for biliopancreatic limb length were 50 cm (50-60), and common channel length were 410 cm (322-520). Statistics for ratios to the small bowel length were 0.23 (0.18-0.27) for alimentary limb, 0.09 (0.07-0.10) for biliopancreatic limb, and 0.69 (0.63-0.73) for common length. There were no significant associations between alimentary limb, biliopancreatic limb, common channel, alimentary limb ratio, biliopancreatic limb ratio or common channel ratio, and either weight loss or improvement in cardiometabolic outcomes.
The common channel length in Roux-en-Y gastric bypass is highly variable between individuals. None of the limb lengths in this study, nor alimentary limb, biliopancreatic limb, or common channel ratios, seem to be related to weight loss or metabolic improvements >7 years.
一些研究表明，体重或代谢结果的变化受 Roux-en-Y 胃旁路术胃肠道肢体长度的影响。
参与者（N=1770）接受了原发性 Roux-en-Y 胃旁路术，并在多中心美国队列研究——减肥手术纵向评估-2 中接受了≤7 年的随访。根据研究方案测量了肠袢和胆胰肠袢的长度；在子样本（N=547）中测量了共同通道。计算了肠袢、胆胰肠袢和共同通道与小肠总长度的比值。
术前中位体重指数为 46（25 至 75 百分位数：43 至 51）kg/m2。肠袢长度的中位数（25 至 75 百分位数）为 125cm（100-150），胆胰肠袢长度为 50cm（50-60），共同通道长度为 410cm（322-520）。与小肠长度的比值分别为肠袢 0.23（0.18-0.27），胆胰肠袢 0.09（0.07-0.10），共同通道 0.69（0.63-0.73）。肠袢、胆胰肠袢、共同通道、肠袢比值、胆胰肠袢比值或共同通道比值与体重减轻或改善代谢结果之间均无显著相关性。
Roux-en-Y 胃旁路术的共同通道长度在个体之间差异很大。本研究中，没有任何肢体长度，也没有肠袢、胆胰肠袢或共同通道比值与 7 年以上的体重减轻或代谢改善有关。
