Shortening of the Common Channel: Further Weight Loss after Gastric Bypass Surgery

Morbid obesity is a growing problem affecting millions of Americans. Bariatric surgery is an effective method to combat obesity in those who have failed diet and exercise attempts. Unfortunately, some patients do not experience satisfactory weight loss after bariatric surgery. We are currently trialing shortening of the common channel as a method for weight loss in patients who have previously undergone Roux-en-Y gastric bypass. Our aim is quantify the weight loss after shortening of the common channel to determine if it is a satisfactory method of further weight loss after Roux-en-Y gastric bypass. Between 2020-2021 we had 16 patients who underwent shortening of the common channel. Weight loss, body mass index (BMI) and excess weight loss (%EWL) were recorded at 3,6,9 and 12 months postoperatively. The mean weight prior to shortening of the common channel was 238 lbs ± 29. BMI prior to shortening of the common channel was 41 kg/m2 ± 4. Patients in the study lost 14 lbs (n=10), 28 lbs (n=9), 40 lbs (n=6) and 57 lbs (n=4) at 3, 6, 9 and 12 months respectively. At 9 months and beyond, patients experienced an 11-point reduction in their BMI, from an average BMI of 41 kg/m2 preoperatively to 29.5 ± 5.6 (n=8). After 9 months patients had a 75% reduction in excess weight. Currently many patients are still undergoing their routine follow up, as their procedures occurred less than a year ago. One patient unfortunately passed away due to consequences of malnutrition secondary to bariatric surgery. Another patient had to receive supplemental nutrition via tube feeds through the gastric remnant. Currently, shortening the common channel offers reasonable weight loss in patients who have unsatisfactory weight loss post gastric bypass but care should be taken as there is a high risk for malnutrition. Further follow-up is needed to continue to evaluate long-term weight loss in these patients and to monitor for malnutrition in subsequent years.