title: The influence of the percentage of the common limb in weight loss and nutritional alterations after laparoscopic gastric bypass.
abstract: BACKGROUND
  Roux-en-Y gastric bypass (RYGB) is considered the gold standard for the treatment of morbid obesity. There is no consensus over ideal limb length when the bypass is created and published studies do not take into account the influence of the common limb (CL) on weight loss. The objective was to study the influence of the common limb after RYGB. The setting was the Virgen de la Arrixaca University Clinical Hospital in Murcia, Spain.
  
  
  METHODS
  This prospective study includes 151 patients undergoing laparoscopic RYGB surgery for morbid obesity. The patients were divided into 2 groups according to their body mass index. The small intestine (SI) was measured using micro forceps so that the percentage of common limb (%CL) could then be compared against the total SI in each patient. The percentage of excess weight loss (%EWL) in relation to the %CL was calculated at 3, 12, and 24 months. A series of tests was conducted simultaneously to analyze nutritional deficiencies and their relation to the %CL.
  
  
  RESULTS
  The total jejunoileal segment and the %CL in the groups of both obese and super-obese patients had no influence on the %EWL in either group for any of the periods studied. The patients with a %CL<50% had greater nutritional deficiencies in the follow-up period and required supplements and more frequent laboratory tests.
  
  
  CONCLUSIONS
  The %CL has no effect on weight loss in RYGB patients. A lower %CL is related to greater nutritional deficiencies.
authors.affiliation: Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain. Electronic address: israelabellanmorcillo@gmail.com.
authors.forename: Israel
authors.initials: I
authors.lastname: Abellan
authors.affiliation: Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Luján
authors.affiliation: Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Frutos
authors.affiliation: Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
authors.forename: Jesus
authors.initials: J
authors.lastname: Abrisqueta
authors.affiliation: Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
authors.forename: Quiteria
authors.initials: Q
authors.lastname: Hernández
authors.affiliation: Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: López
authors.affiliation: Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
authors.forename: Pascual
authors.initials: P
authors.lastname: Parrilla
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000172:deficiency; D001361:Avitaminosis / Q000209:etiology; D002118:Calcium / Q000172:deficiency; D003677:Deficiency Diseases / Q000209:etiology* / Q000473:pathology; D005494:Folic Acid Deficiency / Q000209:etiology; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000473:pathology / Q000601:surgery*; D009929:Organ Size; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D015431:Weight Loss; D055815:Young Adult
chemical_list: D000418:Albumins; D002118:Calcium
keywords: Common limb; Nutritional deficiencies; Roux-en-Y gastric bypass; Weight loss