Objective:

To investigate the effect of long BPL RYGB versus short BPL RYGB on weight loss and metabolic profile in patients with suboptimal clinical response or recurrent weight gain after sleeve gastrectomy, focusing on primary outcomes such as percentage of excess weight loss and metabolic improvements.

Key Findings:

• Both groups showed significant weight loss at 1 year, but the long BPL group had superior outcomes, with a mean excess weight loss of X% compared to Y%.
• Metabolic profiles improved more significantly in the long BPL group compared to the short BPL group, with reductions in HbA1c levels of A% versus B%.
• Surgery-related complications were similar between both groups, with a complication rate of C%.

Interpretation:

Long BPL RYGB may provide better weight loss and metabolic control compared to short BPL RYGB in patients with prior sleeve gastrectomy complications, suggesting a need for further research into optimal surgical strategies.

Limitations:

• The study had a relatively small sample size after dropouts, which may limit the generalizability of the findings.
• Follow-up duration was limited to 1 year, which may not capture long-term outcomes, necessitating longer studies to assess durability.

Conclusion:

Long BPL RYGB is more effective than short BPL RYGB for patients experiencing suboptimal outcomes after sleeve gastrectomy, highlighting its potential as a preferred surgical option.