The tighter the stoma, the greater the loss: A narrower gastrojejunostomy is more beneficial for weight loss following roux‐en‐Y gastric bypass

The optimal size of Gastrojejunostomy (GJ) in Laparoscopic Roux-EnY Gastric Bypass (LRYGB) for a- preferential weight loss is still unknown. This study aimed to investigate the influence of linear-stapled GJ size in long-term LRYGB weight reduction results. We performed a retrospective analysis of 100 patients who underwent LRYGB surgery between January and July 2021. The patients were divided into two 50-patient groups based on the size of their linear-stapled GJ, either 30 or 45 mm. Their weight loss was observed and compared on day 15, and the following appointments were 1, 3, 6, 9, 12, 18, and 24 months after surgery. After 24 months, the 30-mm group reduced their BMI by an average of 19.23, compared with the 16.43 kg/m² of the 45-mm group (p < .001). Overall, repeated measures ANOVA showed a beneficial weight loss pattern for the 30-mm group in all four categories (weight, BMI, EWL, and TWL). Upon adjusting for age, biliopancreatic length, alimentary length, sex, history of diabetes, and a history of hypertension in repeated measures ANOVA, this difference remained significantly in favour of the 30-mm GJ. Based on the results of this study, performing a gastrojejunostomy with a 30-mm stapler compared to a 45-mm stapler increases weight loss in LRYGB patients.