Impact of limb length on nutritional status in One Anastomosis Gastric Bypass: 3 year results

Abstract Background Bariatric-metabolic surgery is a well-established treatment option associated with significant weight-loss and an improvement of metabolic comorbidities. However, the changes in gastrointestinal anatomy frequently result in nutritional deficiencies. Objective To evaluate the impact of biliopancreatic limb (BPL) length in One Anastomosis Gastric Bypass (OAGB) on micronutrient and protein deficiencies. Setting University hospital, Austria Methods All patients that were (i) undergoing OAGB between 2012 and 2014 and (ii) had at least three postoperative follow-up visits were retrospectively analysed. Systemic levels of parathyroid hormone, vitamins (A,D,E,B12), folic acid, magnesium, calcium, iron, albumin and ferritin were correlated to BPL length: short limb (SL;150cm), intermediate limb (IL;200cm) and long limb (LL;250cm). Results A total of 155 patients fulfilled inclusion criteria (female/male: n=111/44). OAGB led to a mean %excess weight loss (%EWL) of 79.9 (+/-24.2) and a reduction of mean body mass index (BMI) from 45.4 kg/m2 (±6.1 kg/m2) at baseline to 30.2kg/m2 (±9.9 kg/m2). Preoperative deficiencies were seen in 25-hydroxy-vitamin D (93.8%), folic acid (27.6%), ferritin (4.1%), vitamin A (5.5%) and vitamin B12 (2.3%). In patients with LL, systemic folic acid levels were significantly lower after 24 months postoperatively when compared to SL and IL (p Conclusion Nutritional deficiencies were common after OAGB without severe deficiencies in BPL lengths ranging from 150 to 250cm. A trend can be observed with more pronounced deficiencies with IL and LL lengths without significant differences for most micronutrients.