Gastric bypass why Roux-en-Y? A review of experimental data

Brendan Collins, Tomoharu Miyashita, Michael A Schweitzer, Thomas Magnuson, John Harmon

Research output: Contribution to journalArticle

Abstract

Objective: To highlight the clinical and experimental rationales that support why the Roux-en-Y limb is an important surgical principle for bariatric gastric bypass. Data Sources: We reviewed PubMed citations for open Roux-en-Y gastric bypass (RYGBP), laparoscopic RYGBP, loop gastric bypass, chronic alkaline reflux gastritis, and duodenoesophageal reflux. Study Selection: We reviewed clinical and experimental articles. Clinical articles included prospective, retrospective, and case series of patients undergoing RYGBP, laparoscopic RYGBP, or loop gastric bypass. Experimental articles that were reviewed included in vivo and in vitro models of chronic duodenoesophageal reflux and its effect on carcinogenesis. Data Extraction and Synthesis: No formal data extraction was performed. We reviewed published operative times, lengths of stay, and anastomotic leak rates for laparoscopic RYGBP and loop gastric bypass. For in vivo and in vitro experimental models of duodenoesophageal reflux, we reviewed the kinetics and potential molecular mechanisms of carcinogenesis. Conclusions: Recent data suggest that laparoscopic loop gastric bypass, performed without the creation of a Roux-en-Y gastroenterostomy, is a faster surgical technique that confers similarly robust weight loss compared with RYGBP or laparoscopic RYGBP. In the absence of a Roux limb, the long-term effects of chronic alkaline reflux are unknown. Animal models and in vitro analyses of chronic alkaline reflux suggest a carcinogenic effect.

Original languageEnglish (US)
Pages (from-to)1000-1003
Number of pages4
JournalArchives of Surgery
Volume142
Issue number10
DOIs
StatePublished - Oct 2007

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Gastric Bypass
Roux-en-Y Anastomosis
Carcinogenesis
Extremities
Bariatrics
Gastroenterostomy
Anastomotic Leak
Information Storage and Retrieval
Gastritis
Operative Time
PubMed
Weight Loss
Length of Stay
Theoretical Models
Animal Models

ASJC Scopus subject areas

  • Surgery

Cite this

Gastric bypass why Roux-en-Y? A review of experimental data. / Collins, Brendan; Miyashita, Tomoharu; Schweitzer, Michael A; Magnuson, Thomas; Harmon, John.

In: Archives of Surgery, Vol. 142, No. 10, 10.2007, p. 1000-1003.

Research output: Contribution to journalArticle

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