Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

The number of obese individuals worldwide continues to increase every year, thus, the number of bariatric/metabolic operations performed is on a constant rise as well. Beside exclusively restrictive procedures, most of the bariatric operations have a more or less malabsorptive component. Several dif...

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Main Authors: Daniel Moritz Felsenreich, Felix Benedikt Langer, Jakob Eichelter, Julia Jedamzik, Lisa Gensthaler, Larissa Nixdorf, Mahir Gachabayov, Aram Rojas, Natalie Vock, Marie Louise Zach, Gerhard Prager
Format: Article
Language:English
Published: MDPI AG 2021-02-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/4/674
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author Daniel Moritz Felsenreich
Felix Benedikt Langer
Jakob Eichelter
Julia Jedamzik
Lisa Gensthaler
Larissa Nixdorf
Mahir Gachabayov
Aram Rojas
Natalie Vock
Marie Louise Zach
Gerhard Prager
author_facet Daniel Moritz Felsenreich
Felix Benedikt Langer
Jakob Eichelter
Julia Jedamzik
Lisa Gensthaler
Larissa Nixdorf
Mahir Gachabayov
Aram Rojas
Natalie Vock
Marie Louise Zach
Gerhard Prager
author_sort Daniel Moritz Felsenreich
collection DOAJ
description The number of obese individuals worldwide continues to increase every year, thus, the number of bariatric/metabolic operations performed is on a constant rise as well. Beside exclusively restrictive procedures, most of the bariatric operations have a more or less malabsorptive component. Several different bypass procedures exist alongside each other today and each type of bypass is performed using a distinct technique. Furthermore, the length of the bypassed intestine may differ as well. One might add that the operations are performed differently in different parts of the world and have been changing and evolving over time. This review evaluates the most frequently performed bariatric bypass procedures (and their variations) worldwide: Roux-en-Y Gastric Bypass, One-Anastomosis Gastric Bypass, Single-Anastomosis Duodeno-Ileal Bypass + Sleeve Gastrectomy, Biliopancreatic Diversion + Duodenal Switch and operations due to weight regain. The evaluation of the procedures and different limb lengths focusses on weight loss, remission of comorbidities and the risk of malnutrition and deficiencies. This narrative review does not aim at synthesizing quantitative data. Rather, it provides a summary of carefully selected, high-quality studies to serve as examples and to draw tentative conclusions on the effects of the bypass procedures mentioned above. In conclusion, it is important to carefully choose the procedure and small bowel length excluded from the food passage suited best to each individual patient. A balance has to be achieved between sufficient weight loss and remission of comorbidities, as well as a low risk of deficiencies and malnutrition. In any case, at least 300 cm of small bowel should always remain in the food stream to prevent the development of deficiencies and malnutrition.
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spelling doaj.art-bbd8cf444c5045f3a2b7e3827a09a4722023-12-03T13:06:02ZengMDPI AGJournal of Clinical Medicine2077-03832021-02-0110467410.3390/jcm10040674Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass ProceduresDaniel Moritz Felsenreich0Felix Benedikt Langer1Jakob Eichelter2Julia Jedamzik3Lisa Gensthaler4Larissa Nixdorf5Mahir Gachabayov6Aram Rojas7Natalie Vock8Marie Louise Zach9Gerhard Prager10Division of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaDivision of General Surgery, Department of Surgery, Vienna Medical University, 1090 Vienna, AustriaThe number of obese individuals worldwide continues to increase every year, thus, the number of bariatric/metabolic operations performed is on a constant rise as well. Beside exclusively restrictive procedures, most of the bariatric operations have a more or less malabsorptive component. Several different bypass procedures exist alongside each other today and each type of bypass is performed using a distinct technique. Furthermore, the length of the bypassed intestine may differ as well. One might add that the operations are performed differently in different parts of the world and have been changing and evolving over time. This review evaluates the most frequently performed bariatric bypass procedures (and their variations) worldwide: Roux-en-Y Gastric Bypass, One-Anastomosis Gastric Bypass, Single-Anastomosis Duodeno-Ileal Bypass + Sleeve Gastrectomy, Biliopancreatic Diversion + Duodenal Switch and operations due to weight regain. The evaluation of the procedures and different limb lengths focusses on weight loss, remission of comorbidities and the risk of malnutrition and deficiencies. This narrative review does not aim at synthesizing quantitative data. Rather, it provides a summary of carefully selected, high-quality studies to serve as examples and to draw tentative conclusions on the effects of the bypass procedures mentioned above. In conclusion, it is important to carefully choose the procedure and small bowel length excluded from the food passage suited best to each individual patient. A balance has to be achieved between sufficient weight loss and remission of comorbidities, as well as a low risk of deficiencies and malnutrition. In any case, at least 300 cm of small bowel should always remain in the food stream to prevent the development of deficiencies and malnutrition.https://www.mdpi.com/2077-0383/10/4/674malabsorptionRoux-en-Y gastric bypassone-anastomosis gastric bypassSADI-Sbiliopancreatic diversionweight regain
spellingShingle Daniel Moritz Felsenreich
Felix Benedikt Langer
Jakob Eichelter
Julia Jedamzik
Lisa Gensthaler
Larissa Nixdorf
Mahir Gachabayov
Aram Rojas
Natalie Vock
Marie Louise Zach
Gerhard Prager
Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures
Journal of Clinical Medicine
malabsorption
Roux-en-Y gastric bypass
one-anastomosis gastric bypass
SADI-S
biliopancreatic diversion
weight regain
title Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures
title_full Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures
title_fullStr Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures
title_full_unstemmed Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures
title_short Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures
title_sort bariatric surgery how much malabsorption do we need a review of various limb lengths in different gastric bypass procedures
topic malabsorption
Roux-en-Y gastric bypass
one-anastomosis gastric bypass
SADI-S
biliopancreatic diversion
weight regain
url https://www.mdpi.com/2077-0383/10/4/674
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