Comparative nutritional, metabolic and body composition effect in patients of Roux-en-Y Gastric Bypass with Long or Short Pancreato-Biliary Limb
DOI:
https://doi.org/10.36105/psrua.2023v3n6.01Palabras clave:
Cirugía bariátrica, Obesidad mórbida, Asa biliopancreática larga, Asa biliopancreática cortaResumen
Introducción: El bypass gástrico laparoscópico en Y de Roux (BPGYR) es una de las técnicas empleada en el tratamiento de la obesidad mórbida. Este estudio comparó el impacto metabólico del la técnica quirúrgica con asa biliopancreática larga (LBP-limb) versus un asa biliopancreática corta (SBP-limb) en pacientes sometidos a BPGYR a los seis, nueve y doce meses después de la cirugía comparando los cambios entre los dos procedimientos. Métodos: Sesenta y cuatro pacientes con obesidad sometidos a BPGYR en dos grupos, uno con asa biliopancreática de 100 cm (SBP-limb) y asa alimentaria de 150 cm (n = 31) y otro con una asa biliopancreática de 200 cm (LBP-limb) y asa alimentaria de 50 cm (n = 33). El peso corporal, grasa corporal (Fat mass), masa libre de grasa (Lean Mass), peso total perdido y parámetros bioquímicos de glucosa, hemoglobina glucosilada (HbA1c), colesterol total, colesterol de baja densidad (c-LDL), colesterol de alta densidad (c-HDL), albúmina fueron comparados a los seis, nueve y doce meses después de la cirugía.
Resultados: Después de la cirugía se observó que en el grupo de LBP-limb existió una mayor pérdida de peso total (P = 0,004) a los doce meses después de la cirugía y un aumento significativo en los niveles de c-HDL a los seis meses (P = 0,001) en comparación con el grupo SBP-limb. Sin embargo, no se encontraron diferencias en la remisión de comorbilidades entre los dos grupos.
Conclusiones: Al finalizar el primer año posoperatorio la técnica LBP-limb generó mayor pérdida de peso.
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Organization, W.H., Obesity and overweight: World Health Organization 2020-2024. Salud Publica Mex. 2022; 522-529. https://doi.org/10.21149/14186 DOI: https://doi.org/10.21149/14186
Fruh, S.M., Obesity: Risk factors, complications, and strategies for sustainable long term weight management. Journal of the American Association of Nurse Practitioners. 2017;29(S1): 3-14. https://doi.org/10.1002/2327-6924.12510 DOI: https://doi.org/10.1002/2327-6924.12510
Chobot, A., et al., Obesity and diabetes-Not only a simple link between two epidemics. Diabetes Metab Res Rev. 2018; 34(7):3042. https://doi.org/10.1002/dmrr.3042 DOI: https://doi.org/10.1002/dmrr.3042
Cohen, J.B., Hypertension in Obesity and the Impact of Weight Loss. Curr Cardiol Rep. 2017;19(10):98. https://doi.org/10.1007/s11886-017-0912-4 DOI: https://doi.org/10.1007/s11886-017-0912-4
Guh, D.P., et al., The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88. https://doi.org/10.1186/1471-2458-9-88 DOI: https://doi.org/10.1186/1471-2458-9-88
Angrisani, L., et al., IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg. 2018; 28;3783-3794. https://doi.org/10.1007/s11695-018-3450-2 DOI: https://doi.org/10.1007/s11695-018-3450-2
Angrisani, L., et al., Bariatric Surgery Worldwide 2013. Obes Surg. 2015; 25(10):1822-32. https://doi.org/10.1007/s11695-015-1657-z DOI: https://doi.org/10.1007/s11695-015-1657-z
Nora, M., et al., Should Roux-en-Y gastric bypass biliopancreatic limb length be tailored to achieve improved diabetes outcomes? Medicine (Balti- more). 2017; 96(48):8859. https://doi.org/10.1097/MD.0000000000008859 DOI: https://doi.org/10.1097/MD.0000000000008859
Kassir, R., Comment on: Long biliopancreatic and short alimentary limb results in more weight loss in revisional RYGB surgery. Outcomes of the randomized controlled ELEGANCE REDO trial. Surg Obes Relat Dis. 2019; 15(1):71-72. https://doi.org/10.1016/j.soard.2018.11.001 DOI: https://doi.org/10.1016/j.soard.2018.11.001
Aiolfi, A., et al., Roux-en-Y gastric bypass: systematic review and Bayesian network meta-analysis comparing open, laparoscopic, and robotic approach. Surg Obes Relat Dis. 2019;15(6):985-994. https://doi.org/10.1016/j.soard.2019.03.006 DOI: https://doi.org/10.1016/j.soard.2019.03.006
Iacobini, C., et al., Metabolically healthy versus metabolically unhealthy obesity. Metabolism. 2019;92: 51- 60. https://doi.org/10.1016/j.metabol.2018.11.009 DOI: https://doi.org/10.1016/j.metabol.2018.11.009
Janochova, K., M. Haluzik, and M. Buzga, Visceral fat and insulin resistance - what we know? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019;163(1):19-27. https://doi.org/10.5507/bp.2018.062 DOI: https://doi.org/10.5507/bp.2018.062
De Lorenzo, A., et al., Why primary obesity is a disease? J Transl Med, 17(1): p. 169. 2019. https://doi.org/10.1186/s12967-019-1919-y DOI: https://doi.org/10.1186/s12967-019-1919-y
Li, C., et al., Estimates of body composition with dual-energy X- ray absorptiometry in adults. Am J Clin Nutr. 2009;90(6):1457-65. https://doi.org/10.3945/ajcn.2009.28141 DOI: https://doi.org/10.3945/ajcn.2009.28141
Maleckas, A., et al., Weight regain after gastric bypass: etiology and treatment options. Gland Surg. 2016; 5(6): p. 617-624. https://doi.org/10.21037/gs.2016.12.02 DOI: https://doi.org/10.21037/gs.2016.12.02
Mason, E.E. and C. Ito, Gastric bypass. Annals of surgery. 1969; 170(3):329. https://doi.org/10.1097/00000658-196909010-00003 DOI: https://doi.org/10.1097/00000658-196909010-00003
Lohman, T.G., A.F. Roche, and R. Martorell, Anthropometric standardization reference manual. Vol. 177. 1988: Human kinetics books Champaign, IL.
Brolin, R.E. and R.P. Cody, Adding malabsorption for weight loss failure after gastric bypass. Surg Endosc. 2007;21(11):1924-6. https://doi.org/10.1007/s00464-007-9542-z DOI: https://doi.org/10.1007/s00464-007-9542-z
Nelson, W.K., et al., The malabsorptive very, very long limb Roux-en-Y gastric bypass for super obesity: results in 257 patients. Surgery. 2006;140(4):517-523. https://doi.org/10.1016/j.surg.2006.06.020 DOI: https://doi.org/10.1016/j.surg.2006.06.020
McConnell, D.B., W. O’Rourke R, and C.W. Deveney, Common channel length predicts outcomes of biliopancreatic diversion alone and with the duodenal switch surgery. Am J Surg. 2005; 189(5):536-40. https://doi.org/10.1016/j.amjsurg.2005.01.023 DOI: https://doi.org/10.1016/j.amjsurg.2005.01.023
McNab, B.K., What determines the basal rate of metabolism? J Exp Biol. 2019; 222:15. https://doi.org/10.1242/jeb.205591 DOI: https://doi.org/10.1242/jeb.205591
Murad, A.J., Jr., et al., A Prospective Single-Arm Trial of Modified Long Biliopancreatic and Short Alimentary Limbs Roux-En-Y Gastric Bypass in Type 2 Diabetes Patients with Mild Obesity. Obes Surg, 28(3): p. 599-605. 2018. https://doi.org/10.1007/s11695-017-2933-x DOI: https://doi.org/10.1007/s11695-017-2933-x
Albaugh, V.L., et al., Bile acids and bariatric surgery. Molecular aspects of medicine.2017;56:75-89. https://doi.org/10.1093/ajcn/82.5.941 DOI: https://doi.org/10.1016/j.mam.2017.04.001
Johnstone, A.M., et al., Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine. Am J Clin Nutr. 2005; 82(5): p. 941-8. https://doi.org/10.1093/ajcn/82.5.941 DOI: https://doi.org/10.1093/ajcn/82.5.941
Nergaard, B.J., et al., Gastric bypass with long alimentary limb or long pancreato-biliary limb--long-term results on weight loss, resolution of co-morbidities and metabolic parameters. Obes Surg. 2014;24(10):1595-602. https://doi.org/10.1007/s11695-014-1245-7 DOI: https://doi.org/10.1007/s11695-014-1245-7
Kaska, L., et al., Improved glucose metabolism following bariatric surgery is associated with increased circulating bile acid concentrations and remodeling of the gut microbiome. World journal of gastroenterology. 2016; 22(39):8698. https://doi.org/10.3748/wjg.v22. i39.8698 DOI: https://doi.org/10.3748/wjg.v22.i39.8698
Shah, K., et al., Distal gastric bypass: 2-m biliopancreatic limb construction with varying lengths of common channel. Surg Obes Relat Dis, 2019;(9):1520-1526. https://doi.org/10.1016/j.soard.2019.05.003 DOI: https://doi.org/10.1016/j.soard.2019.05.003
Don, B.R. and G. Kaysen, Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17(6): 432-7. https://doi.org/10.1111/j.0894-0959.2004.17603.x DOI: https://doi.org/10.1111/j.0894-0959.2004.17603.x
Arques, S., Human serum albumin in cardiovascular diseases. Eur J Intern Med. 2018; 52:8-12. https://doi.org/10.1016/j.ejim.2018.04.014 DOI: https://doi.org/10.1016/j.ejim.2018.04.014
Turicchi J, and col. Associations between the proportion of fat-free mass loss during weight loss, changes in appetite, and subsequent weight change: results from a randomized 2-stage dietary intervention trial. https://doi.org/10.1093/ajcn/nqz331 DOI: https://doi.org/10.1093/ajcn/nqz331
Simonson M, Boirie Y, Guillet C. Protein, amino acids and obesity treatment. Rev Endocr Metab Disord. 2020. 21(3); 341-353. https://doi.org/10.1007/s11154-020-09574-5 DOI: https://doi.org/10.1007/s11154-020-09574-5
Zerrweck C, Herrera A and cols. Long versus short biliopancreatic limb in Roux-en-Y gastric bypass: short-term results of a randomized clinical trial. Surgery for Obesity and Related Diseases. 2021; 1–6. https://doi.org/10.1016/j.soard.2021.03.030 DOI: https://doi.org/10.1016/j.soard.2021.03.030
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Derechos de autor 2023 Leticia del Carmen Guajardo-Montemayor, Rosendo Andrés Rojas-Alvarado, Israel Augusto González-González, Raúl Marín-Domínguez, Francisco José Campos-Pérez, Andrea Ibarra-García, Antonio Ibarra
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