P-B02 Does the length of alimentary limb make a significant difference in the weight loss in Roux en y gastric bypass patients?

Background Roux en Y gastric bypass (RYGB) surgery for morbid obesity is considered as gold standard, but there can be a difference in the length of alimentary and biliopancreatic limb to achieve optimum weight loss. Till now there is no agreed consensus on the ideal limb lengths and their effect on the weight loss. We would like to evaluate the change in the alimentary limb length on the weight loss after the gastric bypass surgery, as a short to medium term single center study. Methods A retrospective analysis from prospectively maintained database of 523 patients who underwent RYGB from 2012 till 2018 was done. Patient who had at least a follow up of 2 years(n = 388) were included. At our center we use alimentary limb of 120 +/- 10 cm for Body Mass Index (BMI) < 40 kg/m2 (group A) and 150+/-10 cm for the BMI >40 kg/m2 (Group B). The biliopancreatic limb length varies from 50 to 70 cm and this does not change with BMI. The percentage excess weight(EWL) loss was measured and analyzed at 1st and 2nd year post operatively. We used paired t test to check for statistical significance. Results There were 172 patients in Group A and 216 in Group B. The number of females were 330 and males were 58. The average age was 44 years . The mean preoperative BMI for the 120 cm limb group was 37.1 kg/m2 and that for 150 cm limb was 45.3kg/m2. The EWL for the group A at 1 year and 2 year post op was a Mean and standard deviation of 79.3% +/- 39.4% and 78.3% +/- 35.2% respectively and for group B was 58.8% +/- 26.6% and 58.6% +/- 23.2% respectively. The difference was statistically significant (p < 0.001) . The analysis and interpretation for metabolic syndrome is yet to be determined. Conclusions In our study, Increasing the alimentary limb length for higher BMI reduced EWL. This is consistent with few other publications regarding the same. This has resulted in a change in our practice namely keeping the length of alimentary limb constant and varying the BP limb length. We will be analyzing and presenting this data in future.