Lengthening the Roux-Y Limb Increases Weight Loss after Gastric Bypass: a preliminary report.

We compared two variants of gastric bypass which have been used at our hospital since 1984. Initially all patients had a standard 45 cm Roux-Y anastomosed to a 30 cc gastric pouch. Subsequently we increased the length of the Roux-Y from 45 to 90 cm. In all patients the jejunum was divided 15-20 cm from the ligament of Treitz. There were six males, and 49 females with a mean age of 35 years. All were at least twice their ideal weights (range 91.5 to 179, X = 127.6). Percentage follow-up ranged from 100% at three months to 13% at 66 months for both the standard and lengthened Roux-Y groups. There were no major technical or metabolic complications. Doubling the length of the standard Roux-Y limb increased the percentage excess weight lost by approximately 6% without diarrhea or other apparent metabolic, sequelae.