Nutrient absorption, feed intake and liveweight change as a consequence of Roux-en-Y gastric bypass with increasing alimentary limb lengths in the pig model.
Hodgkinson, Suzanne Marie
Roux-en Y gastric bypass (RYGBP) combines a restrictive and malabsortive component of the digestive system. Metabolic outcomes of increasing the latter, is a matter of research interest. The aim of this study was to evaluate the nutritional consequences of RYGBP with different alimentary limb lengths using a pig model. Twenty-six pigs were randomly assigned to four laparoscopic procedures: RYGBP with 300 cm of alimentary limb (T300); RYGBP with 600 cm (T600); RYGBP with 900 cm (T900); sham operation (TS). RYGBP consisted of creating a proximal gastric pouch with a 300, 600 and 900 cm alimentary limb. Sham operation was performed by bowel transections and reanastomosis in the ileum and proximal jejunum together with gastrotomy and closure. Animals were evaluated weekly for weight increase and monthly for food intake. Eighteen weeks after surgery, fecal in vivo apparent digestibility of protein, fat, fiber, calcium and phosphorous were determined. We performed ANOVA and Tukey tests to detect differences in weight, feed intake and digestibility. We observed significant differences in liveweight after 10 weeks among T300, T600 and T900 as compared to TS. No differences were found among T300, T600 and T900. We also observed significant differences in feed intake among T300, T600 and T900 versus TS. No differences among treatments for digestibility of fat; fiber; protein and energy were found. Calcium and phosphorous apparent digestibility differed among treatments. RYGBP reduced weight increase in the porcine model and calcium and phosphorous digestibility was reduced with longer limbs.