An Extended Pouch in a Roux-En-Y Gastric Bypass Reduces Weight Regain: 3-Year Results of a Randomized Controlled Trial

Overview

Journal Obes Surg

Date 2019 Aug 25

PMID 31444776

Citations 8

Authors

Abel Boerboom

Mellody Cooiman

Edo Aarts

Theo Aufenacker

Eric Hazebroek

Frits Berends

Affiliations

Soon will be listed here.

Abstract

Background: Although the Roux-en-Y gastric bypass (RYGB) is considered a standard procedure, many variations exist in the basic design. In order to achieve more pronounced and sustainable results after RYGB, factors such as diameter of the gastroenterostomy, limb length, and pouch size are gripping points for improvement of design. Extending the pouch could improve results by altering food passage through the pouch.

Objective: The aim of this randomized controlled trial was to evaluate the effect of an extended pouch RYGB (EP-GB) and standard pouch RYGB (S-GB).

Methods: In total, 132 patients were randomized in two groups: 68 patients received an EP-GB (pouch length 10 cm) and 64 a S-GB (pouch length 5 cm). Subsequently, weight loss, remission of comorbidities, nutritional status, complications, quality of life, and GERD-symptoms were assessed during a follow-up of 3 years.

Results: During the first 2 years of follow-up, no significant differences in terms of weight loss were observed. In the third year of follow-up, the S-GB group regained 3 kg, while in the EP-GB group no weight regain was observed. The mean TBWL after 36 months in the EP-GB group was 31% versus 27% in the S-GB group (p = 0.023). Additionally, besides a better remission rate of hypertension in the EP-GB group, no differences in complications, quality of life, and GERD-symptoms were found.

Conclusion: Creation of an extended gastric pouch is a safe and effective modification in RYGB design. An EP-GB improves mid-term weight loss, potentially driven by a lower occurrence of weight regain.

Citing Articles

Roux-en-Y Gastric Bypass: Revisiting Gastric Pouch Length Variability in Search of Consensus.

Ammar M, Ibrahim A, Aly M, Eltaia M, Zidan M Obes Surg. 2025; 35(3):1197-1198.

PMID: 39985714 DOI: 10.1007/s11695-025-07758-z.

Five-year outcomes of a randomized controlled trial evaluating a non-adjustable ring in Roux-en-Y gastric bypass.

Okkema S, Boerboom A, den Hengst W, Aarts E, Berends F, Hazebroek E Surg Endosc. 2025; .

PMID: 39953277 DOI: 10.1007/s00464-025-11545-3.

Outcomes and complications after long versus short gastric pouch Roux-en-Y gastric bypass in patients with severe obesity.

Safari S, Ekramnia I, Chehresonboll Y, Ahmadi V, Kermansaravi M Sci Rep. 2024; 14(1):31012.

PMID: 39730809 PMC: 11681075. DOI: 10.1038/s41598-024-82200-5.

Long Narrow Pouch Roux-en-Y Gastric Bypass (LN-RYGB) for Recurrent Weight Gain After Sleeve Gastrectomy.

Hu S, Wang C, Dong Z, Yang W Obes Surg. 2024; 34(9):3509-3512.

PMID: 39042311 DOI: 10.1007/s11695-024-07412-0.

Randomized controlled trials comparing gastric bypass, gastric band, and sleeve gastrectomy: A systematic review examining validity and applicability to wider clinical practice.

Chalmers K, Cousins S, Blazeby J Obes Rev. 2024; 25(5):e13718.

PMID: 38346786 PMC: 11478934. DOI: 10.1111/obr.13718.

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