The aim of this study was to determine whether longer limb length improved
results of gastric bypass in patients who were morbidly obese (body mass in
dex < 50 kg/m(2)) or superobese (body mass index > 50 kg/m(2)). A total of
242 patients were followed for a mean of 5.5 years. The standard operation
was a Roux-en-Y gastric bypass with a 40 cm Roux limb and a to cm afferent
limb. The long-limb operation had a 100 cm Roux limb and a 100 cm afferent
limb. Morbidly obese patients did not benefit from a long-limb bypass. The
final body mass index was 28.6 +/- 4.7 kg/m(2) in the short-limb group and
28.5 +/- 3.8 kg/m(2) in the long-limb group. The superobese patients did be
nefit from a long-limb bypass. Final body mass index was 35.8 +/- 6.7 kg/m(
2) in the short-limb patients and 32.7 +/- 5.1 in the long-limb patients (P
= 0.049). A subgroup of 20 patients, all of whom had a body mass index gre
ater than 60 kg/m(2), benefited the most from long-limb by-pass. No macronu
tritional side effects unique to the long-limb bypass were encountered.