Optimal Bilio-Pancreatic Limb (BPL) Length in One Anastomosis Gastric Bypass (OAGB) Surgery.

BACKGROUND

One Anastomosis Gastric Bypass (OAGB) is a modification of Mason's loop bypass procedure, which has become a well-established procedure in the field of Bariatric and Metabolic surgery (BMS). However, the optimal length of Biliopancreatic Limb (BPL) in OAGB remains an ongoing debate.

OBJECTIVE

This review aims to analyse the current trends and evidence regarding different BPL lengths in OAGB and their impact on outcomes.

METHODS

A comprehensive literature search using search terms, 'One Anastomosis Gastric Bypass', 'Mini-Gastric Bypass', 'Biliopancreatic Limb', and 'Small bowel limb' was conducted. The articles were extracted and critically appraised for various outcomes including weight loss, comorbidities resolution, nutritional deficiencies, complications and quality of life.

RESULTS

There appears to be a direct relationship between length of the BPL and the incidence of malnutrition. Longer BPL lengths (> 200 cm) are associated with a higher risk of malnutrition. Shorter BPL lengths (150-200 cm), particularly 150 cm, have shown promising outcomes.

CONCLUSION

Shorter BPL lengths offer potential advantages by reducing nutritional risks associated with OAGB. Further research with long-term follow-up is needed to investigate the efficacy of even shorter BPL lengths (< 150 cm).