Impact of Gastrojejunostomy Anastomosis Diameter on Weight Loss Following Laparoscopic Gastric Bypass: A Systematic Review

Al-Fagih, O.S; Zuberi , S; Niaz, O; Jambulingam , P; Whitelaw, D; Rashid, F; Adil, M.T; Jain, V; Al-Taan, O; Munasinghe, A; Askari , A; Iqbal , FM

Impact of Gastrojejunostomy Anastomosis Diameter on Weight Loss Following Laparoscopic Gastric Bypass: A Systematic Review

Authors

Al-Fagih, O.S

Zuberi , S

Niaz, O

Jambulingam , P

Whitelaw, D

Rashid, F

Adil, M.T

Jain, V

Al-Taan, O

Munasinghe, A

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Issue Date

2024

Type

Published Abstract

Keywords

Research Subject Categories::MEDICINE::Surgery

Abstract

Abstract Laparoscopic Roux-en-Y gastric bypass (RYGB) is crucial for significant weight reduction and treating obesity-related issues. However, the impact of gastrojejunostomy (GJ) anastomosis diameter on weight loss remains unclear. We investigate this influence on post-RYGB weight loss outcomes. A systematic search was conducted. Six studies met the inclusion criteria, showing varied GJ diameters and follow-up durations (1-5 years). Smaller GJ diameters generally correlated with greater short-to-medium-term weight loss, with a threshold beyond which complications like stenosis increased. Studies had moderate-to-low bias risk, emphasizing the need for precise GJ area quantification post-operation. This review highlights a negative association between smaller GJ diameters and post-RYGB weight loss, advocating for standardized measurement techniques. Future research should explore intra-operative and AI-driven methods for optimizing GJ diameter determination. Keywords: Bariatric surgery; GJ diameter; Gastroenterostomy diameter; Gastrojejunostomy diameter; Laparoscopic Roux-en-Y gastric bypass (RYGB); Outcomes; Stenosis; Weight loss. © 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. PubMed Disclaimer Similar articles The tighter the stoma, the greater the loss: A narrower gastrojejunostomy is more beneficial for weight loss following roux-en-Y gastric bypass. Kalali K, Zandbaf T, Esparham A, Ahmadyar S, Jangjoo A, Meshkat M, Kalantari ME, Ghamari MJ, Rezapanah A, Dalili A. Clin Obes. 2025 Aug;15(4):e70013. doi: 10.1111/cob.70013. Epub 2025 May 18. PMID: 40384040 Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Chapman AE, Kiroff G, Game P, Foster B, O'Brien P, Ham J, Maddern GJ. Surgery. 2004 Mar;135(3):326-51. doi: 10.1016/S0039-6060(03)00392-1. PMID: 14976485 Three-Year Results of Comparison Between Ring- versus Non-ring-Augmented Roux-en-Y Gastric Bypass: A Randomized Control Trial. Hany M, Zidan A, Ibrahim M, Elbahrawy A, Mourad M, Abouelnasr AA, Hany ZM, Torensma B. Obes Surg. 2025 Aug;35(8):2812-2827. doi: 10.1007/s11695-025-08034-w. Epub 2025 Jul 17. PMID: 40676351Free PMC article.Clinical Trial. Comparison of metabolic outcomes in patients undergoing laparoscopic roux-en-Y gastric bypass versus sleeve gastrectomy - a systematic review and meta-analysis of randomised controlled trials. Hayoz C, Hermann T, Raptis DA, Brönnimann A, Peterli R, Zuber M. Swiss Med Wkly. 2018 Jul 5;148:w14633. doi: 10.57187/smw.2018.14633. eCollection 2018. PMID: 30035801 Outcomes of Mini vs Roux-en-Y gastric bypass: A meta-analysis and systematic review. Wang FG, Yan WM, Yan M, Song MM. Int J Surg. 2018 Aug;56:7-14. doi: 10.1016/j.ijsu.2018.05.009. Epub 2018 May 16. PMID: 29753952 See all similar articles References Small P, Mahawar K et al. The United Kingdom National Bariatric Surgery Registry 3rd Report. 2020. IFSO. Global Registry Eighth report. 2023. https://www.ifso.com/pdf/8th-ifso-registry-report-2023.pdf . Courcoulas A, Coley RY, Clark JM, et al. Interventions and operations 5 years after bariatric surgery in a cohort from the US national patient-centered clinical research network bariatric study. JAMA Surg. 2020;155(3):194. - DOI - PubMed - PMC Pucci A, Batterham RL. Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different. J Endocrinol Invest. 2019;42(2):117–28. - DOI - PubMed Kamocka A, Chidambaram S, Erridge S, et al. Length of biliopancreatic limb in Roux-en-Y gastric bypass and its impact on post-operative outcomes in metabolic and obesity surgery—systematic review and meta-analysis. Int J Obes. 2022;46(11):1983–91. - DOI

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Citation

Al-Fagih OS, Zuberi S, Niaz O, Jambulingam P, Whitelaw D, Rashid F, Adil MT, Jain V, Al-Taan O, Munasinghe A, Askari A, Iqbal FM. Impact of Gastrojejunostomy Anastomosis Diameter on Weight Loss Following Laparoscopic Gastric Bypass: A Systematic Review. Obes Surg. 2024 Jun;34(6):2227-2236. doi: 10.1007/s11695-024-07237-x. Epub 2024 Apr 23. PMID: 38652437.