Is Small Bowel Length Measurement Necessary for Roux-en-Y Gastric Bypasses (RYGBP) to Prevent Malnutrition?

Background: Roux-en-Y gastric bypass (RYGBP) has received a lot of attention with the prevalence of obesity. However, some patients report more weight loss and more malnutrition, which is thought to be due to differences in common Limb length (CLL) in patients. Surgeons reported alimentary limb length (ALL) and biliopancreatic limb length (BPLL), and CLL is generally unknown. Methods: During 2015-2017, this study was conducted among 600 patients to evaluate CLL and excessive weight loss (EWL) and malnutrition in patients undergoing RYGBP. To measure the length of the small intestine, 30 minutes after the start of the surgery, the measurement was performed by micro forceps and grasping the midpart of the small intestine and, the average measurement time was 7 minutes. Results: the median length of the small bowel was 712 cm. The results of this study showed that patients with CLL ˂650 cm had more EWL% and malnutrition than CLL >750 cm. Conclusion: Since 0.5% and 2% of the participants in this study had a small bowel length of fewer than 4 m and 4.5 m, respectively, and assuming that the ALL + CLL should be more than 3 m, the length of the small bowel was usually bypassed in these people is 2 meters. If the BPLL is less than 125 cm, small bowel measurement is not necessary, but if it is higher than 125 cm, 2% of people will have the chance of shortness of small bowel and it is better to measure the length of the intestine.