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 increasing prevalence of obesity. However, some patients report more weight loss and malnutrition, which is thought to be due to differences in Common Limb Length (CLL) in patients. Surgeons reported the Alimentary Limb Length (ALL) and biliopancreatic limb length (BPLL), but CLL is generally unknown. Methods and Materials: This study was conducted on 600 patients undergoing RYGBP to evaluate CLL and Excessive Weight Loss (EWL) and malnutrition in Tehran City, Iran, from 2015 to 2017. Thirty minutes after the start of the surgery, the length of the small intestine the measurement was measured with micro forceps by grasping the midpart of the small intestine. The average measurement took seven minutes. Results: The median length of the small bowel was 712 cm. This study showed that patients with CLL of less than 650 cm had more EWL% and malnutrition than those with CLL of more than 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 bypassed small bowel in these people is usually 2 m. If the BPLL is less than 125 cm, small bowel measurement is not necessary, but if it is longer than 125 cm, 2% of people may have shortness of small bowel, and it is better to measure the length of the intestine.