ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet10161ometendo-10161Research ArticleОбзор литературыReviewЖелудочное шунтирование в современной бариатрической хирургииGastric bypass in modern bariatric surgeryhttps://orcid.org/0000-0002-1840-114XОспановОрал БазарбаевичOspanovOral B.

д.м.н., профессор

MD, PhD, Professor

bariatric.kz@gmail.comhttps://orcid.org/0000-0001-5916-2897ЕлеуовГалымжан АлмасбековичYeleuovGalymzhan A.

к.м.н.

MD, PhD

g.eleuov@mai.ruhttps://orcid.org/0000-0002-6634-5728БекмурзиноваФарида КайратовнаBekmurzinovaFarida K.

клинический ординатор

resident

farida_1996_8@mail.ruМедицинский университет Астана; Республиканское общественное объединение «Казахстанское общество бариатрических и метаболических хирургов». КазахстанAstana Medical University; Society of bariatric and metabolic surgery of KazakhstanKazakhstanКорпоративный фонд «University Medical Center»КазахстанCorporate Foundation «University Medical Center»Kazakhstan202021092020172130137Copyright © Оспанов О.Б., Елеуов Г.А., Бекмурзинова Ф.К., 20202020Оспанов О.Б., Елеуов Г.А., Бекмурзинова Ф.К.Ospanov O.B., Yeleuov G.A., Bekmurzinova F.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/10161

Желудочное шунтирование по методу Ру долгое время считалось золотым стандартом хирургического лечения ожирения и его осложнений. Но в настоящее время это положение оспаривается сторонниками одноанастомозного гастрошунтирования и продольной рукавной резекции желудка. Снижение доли гастрошунтирования в структуре бариатрических операций объясняется технической сложностью, хирургическими и мальабсорбтивными осложнениями. В представленном обзоре отражена основная роль гастрошунтирования как бариатрической операции в лечении ожирения и метаболического синдрома, раскрыты различные варианты технического проведения гастрошунтирования по Ру и альтернативного одноанастомозного желудочного шунтирования. Показаны преимущества и недостатки степлерного и бесстеплерного методов выполнения бариатрических операций. На наш взгляд, одной из перспективных альтернативных концепций хирургического лечения ожирения является бесстеплерное одноанастомозное направление в желудочном шунтировании, но известные бесстеплерные методы несовершенны и небезопасны. Таким образом, исходя из представленного обзора литературы, можно сделать вывод о несовершенстве не только степлерных методов гастрошунтирования, но и бесстеплерного метода. Поэтому необходим дальнейший поиск альтернативных оперативных методов, которые бы позволили снизить вероятность хирургических осложнений, уменьшить затратность бариатрических операций и повысить доступность хирургического лечения ожирения для населения.

The Roux-en-Y Gastric bypass surgery has long been considered as the «gold standard» method for the surgical treatment of obesity and its complications. But at present, this position is disputed by supporters of one-anastomotic gastric bypass and sleeve gastrectomy. The decrease in the share of gastric bypass in the structure of bariatric operations is explained by technical complexity, surgical and malabsorption complications. This review reflects the main role of gastric bypass as a bariatric surgery in the treatment of obesity and metabolic syndrome, and discloses various options for the technical implementation of gastric bypass surgery according to Roux-en-Y and alternative one-anastomotic gastric bypass surgery. The advantages and disadvantages of the stapler-use and stapleless method for performing bariatric operations are shown. In our opinion, one of the promising alternative concepts for the surgical treatment of obesity is stapleless one-anastomotic direction in gastric bypass surgery, but the known stapleless methods are imperfect and unsafe. Thus, based on the presented literature review, we can conclude that the imperfection of not only the stapler gastric bypass methods, but also the stapleless method. Therefore, a further research is needed for alternative surgical methods that would reduce the likelihood of surgical complications, reduce the cost of bariatric surgery and increase the accessibility of surgical treatment of obesity for the population.

ожирениебариатрическая хирургияжелудочное шунтированиегастрошунтирование по Румини-гастрошунтирование/одноанастомозное гастрошунтированиеobesitybariatric surgerygastric bypassRoux-en-Y gastric bypassmini gastric bypass - one anastomosis gastric bypassReferencesСедлецкий Ю.И., Мирчук К.К. Хирургическое лечение ожирения. // Вестник хирургии им. И.И. Грекова. — 1996. — Т. 155. — №6. — С. 100-104. [Sedletskiy YI, Mirchuk KK. Khirurgicheskoe lechenie ozhireniya. Vestn Khir Im I I Grek. 1996;155(6):100-104. (In Russ.)]Седлецкий Ю.И., Мирчук К.К. Хирургическое лечение ожирения. // Вестник хирургии им. И.И. Грекова. — 1996. — Т. 155. — №6. — С. 100-104. [Sedletskiy YI, Mirchuk KK. Khirurgicheskoe lechenie ozhireniya. Vestn Khir Im I I Grek. 1996;155(6):100-104. (In Russ.)]Яшков Ю.И. Стандарты в бариатрической и метаболической хирургии (по материалам международных согласительных конференций). // Ожирение и метаболизм. — 2008. — Т. 5. — №3. — C. 17-21. [Yashkov YI. Standarty v bariatricheskoy i metabolicheskoy khirurgii (po materialam mezhdunarodnykh soglasitel’nykh konferentsiy). Obesity and metabolism. 2008;5(3):17-21. (In Russ.)] DOI:10.14341/2071-8713-5332Яшков Ю.И. Стандарты в бариатрической и метаболической хирургии (по материалам международных согласительных конференций). // Ожирение и метаболизм. — 2008. — Т. 5. — №3. — C. 17-21. [Yashkov YI. Standarty v bariatricheskoy i metabolicheskoy khirurgii (po materialam mezhdunarodnykh soglasitel’nykh konferentsiy). Obesity and metabolism. 2008;5(3):17-21. (In Russ.)] DOI:10.14341/2071-8713-5332Дедов И.И., Мельниченко Г.А., Шестакова М.В., и др. Национальные клинические рекомендации по лечению морбидного ожирения у взрослых. 3-ий пересмотр (лечение морбидного ожирения у взрослых). // Ожирение и метаболизм. — 2018. — Т. 15. — №1. — С. 53-70. [Dedov II, Mel’nichenko GA, Shestakova MV, et al. Russian national clinical recommendations for morbid obesity treatment in adults. 3rd revision (Morbid obesity treatment in adults). Obesity and metabolism. 2018;15(1):53-70. (In Russ.)]Дедов И.И., Мельниченко Г.А., Шестакова М.В., и др. Национальные клинические рекомендации по лечению морбидного ожирения у взрослых. 3-ий пересмотр (лечение морбидного ожирения у взрослых). // Ожирение и метаболизм. — 2018. — Т. 15. — №1. — С. 53-70. [Dedov II, Mel’nichenko GA, Shestakova MV, et al. Russian national clinical recommendations for morbid obesity treatment in adults. 3rd revision (Morbid obesity treatment in adults). Obesity and metabolism. 2018;15(1):53-70. (In Russ.)]Неймарк А.Е., Седлецкий Ю.И., Анисимова К.А. Метаболические эффекты бариатрических операций. // Вестник хирургии имени ИИ Грекова. — 2013. — Т. 172. — №6. — C. 104-107. [Neimark AE, Sedletskii YI, Anisimova KA. Metabolicheskie effekty bariatricheskikh operatsii. Vestn Khir Im I I Grek. 2013;172(6):104-107. (In Russ.)]Неймарк А.Е., Седлецкий Ю.И., Анисимова К.А. Метаболические эффекты бариатрических операций. // Вестник хирургии имени ИИ Грекова. — 2013. — Т. 172. — №6. — C. 104-107. [Neimark AE, Sedletskii YI, Anisimova KA. Metabolicheskie effekty bariatricheskikh operatsii. Vestn Khir Im I I Grek. 2013;172(6):104-107. (In Russ.)]Яшков Ю.И., Луцевич О.Э., Бордан Н.С., Ивлева О.В. Продольная резекция желудка при ожирении-результаты 5-летних наблюдений. // Клиническая и экспериментальная хирургия. Журнал имени академика Б.В. Петровского. — 2016. — Т. 4. — №1. — С. 27-37. [Yashkov YI, Lutsevich OE, Bordan NS, Ivleva OV. Sleeve gastrectomy for morbid obesity - results of 5-year observation. Klinicheskaya i eksperimental’naya khirurgiya. Zhurnal imeni akademika B.V. Petrovskogo. 2016;4(1):27-37. (In Russ.)]Яшков Ю.И., Луцевич О.Э., Бордан Н.С., Ивлева О.В. Продольная резекция желудка при ожирении-результаты 5-летних наблюдений. // Клиническая и экспериментальная хирургия. Журнал имени академика Б.В. Петровского. — 2016. — Т. 4. — №1. — С. 27-37. [Yashkov YI, Lutsevich OE, Bordan NS, Ivleva OV. Sleeve gastrectomy for morbid obesity - results of 5-year observation. Klinicheskaya i eksperimental’naya khirurgiya. Zhurnal imeni akademika B.V. Petrovskogo. 2016;4(1):27-37. (In Russ.)]Buchwald H, Oien DM. Metabolic/bariatric surgery Worldwide 2008. Obes Surg. 2009;19(12):1605-1611. DOI:10.1007/s11695-009-0014-5Buchwald H, Oien DM. Metabolic/bariatric surgery Worldwide 2008. Obes Surg. 2009;19(12):1605-1611. DOI:10.1007/s11695-009-0014-5Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg. 2018;28(12):3783-3794. DOI:10.1007/s11695-018-3450-2Angrisani L, Santonicola A, Iovino P, et al. IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg. 2018;28(12):3783-3794. DOI:10.1007/s11695-018-3450-2Феденко В.В., Евдошенко В.В., Курганов И.А., и др. Сравнительный анализ эффективности лапароскопической рукавной резекции желудка и лапароскопического желудочного шунтирования у больных с сахарным диабетом 2-го типа и нарушением толерантности к глюкозе. // Эндоскопическая хирургия. — 2016. — Т. 22. — №2. — С. 21-31. [Fedenko VV, Evdoshenko VV, Kurganov IA, et al. Comparative analysis of laparoscopic sleeve gatrectomy and laparoscopic gastric bypass surgery in patients with type 2 diabetes mellitus and impaired glucose tolerance. Endoskopicheskaia khirurgiia. 2016;22(2):21-31. (In Russ.)] DOI:10.17116/endoskop201622221-31Феденко В.В., Евдошенко В.В., Курганов И.А., и др. Сравнительный анализ эффективности лапароскопической рукавной резекции желудка и лапароскопического желудочного шунтирования у больных с сахарным диабетом 2-го типа и нарушением толерантности к глюкозе. // Эндоскопическая хирургия. — 2016. — Т. 22. — №2. — С. 21-31. [Fedenko VV, Evdoshenko VV, Kurganov IA, et al. Comparative analysis of laparoscopic sleeve gatrectomy and laparoscopic gastric bypass surgery in patients with type 2 diabetes mellitus and impaired glucose tolerance. Endoskopicheskaia khirurgiia. 2016;22(2):21-31. (In Russ.)] DOI:10.17116/endoskop201622221-31Sudan R, Jacobs DO. Biliopancreatic diversion with duodenal switch. Surg Clin North Am. 2011;91(6):1281-1293, ix. DOI:10.1016/j.suc.2011.08.015Sudan R, Jacobs DO. Biliopancreatic diversion with duodenal switch. Surg Clin North Am. 2011;91(6):1281-1293, ix. DOI:10.1016/j.suc.2011.08.015Цветков Б.Ю., Степанов Д.Ю., Мешков С.В., Соколов А.Б., и др. Сравнение различных модификаций лапароскопического гастрошунтирования при лечении патологического ожирения // Московский хирургический журнал. — 2008. — №4. — С. 27-28. [Tsvetkov BY, Stepanov DY, Meshkov SV, Sokolov AB, et al. Sravnenie razlichnykh modifikatsiy laparoskopicheskogo gastroshuntirovaniya pri lechenii patologicheskogo ozhireniya. Moskovskiy khirurgicheskiy zhurnal. 2008;(4):27-28. (In Russ.)]Цветков Б.Ю., Степанов Д.Ю., Мешков С.В., Соколов А.Б., и др. Сравнение различных модификаций лапароскопического гастрошунтирования при лечении патологического ожирения // Московский хирургический журнал. — 2008. — №4. — С. 27-28. [Tsvetkov BY, Stepanov DY, Meshkov SV, Sokolov AB, et al. Sravnenie razlichnykh modifikatsiy laparoskopicheskogo gastroshuntirovaniya pri lechenii patologicheskogo ozhireniya. Moskovskiy khirurgicheskiy zhurnal. 2008;(4):27-28. (In Russ.)]Ikramuddin S, Korner J, Lee WJ, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA. 2013;309(21):2240-2249. DOI:10.1001/jama.2013.5835Ikramuddin S, Korner J, Lee WJ, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA. 2013;309(21):2240-2249. DOI:10.1001/jama.2013.5835Mason EE, Printen KJ, Hartford CE, Boyd WC. Optimizing results of gastric bypass. Ann Surg. 1975;182(4):405-414. DOI:10.1097/00000658-197510000-00006Mason EE, Printen KJ, Hartford CE, Boyd WC. Optimizing results of gastric bypass. Ann Surg. 1975;182(4):405-414. DOI:10.1097/00000658-197510000-00006Jirapinyo P, Dayyeh BK, Thompson CC. Gastrojejunal anastomotic reduction for weight regain in roux-en-y gastric bypass patients: physiological, behavioral, and anatomical effects of endoscopic suturing and sclerotherapy. Surg Obes Relat Dis. 2016;12(10):1810-1816. DOI:10.1016/j.soard.2016.09.036Jirapinyo P, Dayyeh BK, Thompson CC. Gastrojejunal anastomotic reduction for weight regain in roux-en-y gastric bypass patients: physiological, behavioral, and anatomical effects of endoscopic suturing and sclerotherapy. Surg Obes Relat Dis. 2016;12(10):1810-1816. DOI:10.1016/j.soard.2016.09.036Griffen WO, Jr., Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg. 1977;186(4):500-509. DOI:10.1097/00000658-197710000-00012Griffen WO, Jr., Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg. 1977;186(4):500-509. DOI:10.1097/00000658-197710000-00012Svanevik M, Risstad H, Hofso D, et al. Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50-60 kg/m(2)--A Double-Blind, Randomized Controlled Trial. Obes Surg. 2015;25(10):1788-1795. DOI:10.1007/s11695-015-1621-ySvanevik M, Risstad H, Hofso D, et al. Perioperative Outcomes of Proximal and Distal Gastric Bypass in Patients with BMI Ranged 50-60 kg/m(2)--A Double-Blind, Randomized Controlled Trial. Obes Surg. 2015;25(10):1788-1795. DOI:10.1007/s11695-015-1621-yBuchwald H. Buchwald’s Atlas of Metabolic and Bariatric Surgical Techniques and Procedures. Philadelphia: Elsevier/Saunders; 2012.Buchwald H. Buchwald’s Atlas of Metabolic and Bariatric Surgical Techniques and Procedures. Philadelphia: Elsevier/Saunders; 2012.Stefanidis D, Kuwada TS, Gersin KS. The importance of the length of the limbs for gastric bypass patients--an evidence-based review. Obes Surg. 2011;21(1):119-124. DOI:10.1007/s11695-010-0239-3Stefanidis D, Kuwada TS, Gersin KS. The importance of the length of the limbs for gastric bypass patients--an evidence-based review. Obes Surg. 2011;21(1):119-124. DOI:10.1007/s11695-010-0239-3Яшков Ю.И., Седлецкий Ю.И., Василевский Д.И., и др. Повторные вмешательства в бариатрической хирургии. // Педтатр. — 2019. — Т. 10. — №3. — С. 81-91. [Yashkov YI, Sedletskiy YI, Vasilevskiy DI, et al. Revision procedures in bariatric surgery. Pediatrician (St. Petersburg). 2019;10(3):81-91. (In Russ.)] DOI:10.17816/ped10381-91Яшков Ю.И., Седлецкий Ю.И., Василевский Д.И., и др. Повторные вмешательства в бариатрической хирургии. // Педтатр. — 2019. — Т. 10. — №3. — С. 81-91. [Yashkov YI, Sedletskiy YI, Vasilevskiy DI, et al. Revision procedures in bariatric surgery. Pediatrician (St. Petersburg). 2019;10(3):81-91. (In Russ.)] DOI:10.17816/ped10381-91Sugerman H. Conversion of proximal to distal gastric bypass for failed gastric bypass for superobesity. J Gastrointest Surg. 1997;1(6):517-524. DOI:10.1016/s1091-255x(97)80067-4Sugerman H. Conversion of proximal to distal gastric bypass for failed gastric bypass for superobesity. J Gastrointest Surg. 1997;1(6):517-524. DOI:10.1016/s1091-255x(97)80067-4Escalona A, Devaud N, Perez G, et al. Antecolic versus retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass: a comparative study. Surg Obes Relat Dis. 2007;3(4):423-427. DOI:10.1016/j.soard.2007.04.005Escalona A, Devaud N, Perez G, et al. Antecolic versus retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass: a comparative study. Surg Obes Relat Dis. 2007;3(4):423-427. DOI:10.1016/j.soard.2007.04.005Фишман М.Б. Модифицированный метод операции лапароскопического желудочного шунтирования. // Вестник хирургии имени ИИ Грекова. — 2017. — Т. 176. — №2. — С. 100-106. [Fishman MB. Modified method of laparoscopic gastric bypass surgery. Vestn Khir Im I I Grek. 2017;176(2):100-106. (In Russ.)]Фишман М.Б. Модифицированный метод операции лапароскопического желудочного шунтирования. // Вестник хирургии имени ИИ Грекова. — 2017. — Т. 176. — №2. — С. 100-106. [Fishman MB. Modified method of laparoscopic gastric bypass surgery. Vestn Khir Im I I Grek. 2017;176(2):100-106. (In Russ.)]Фишман М.Б., Седов В.М., Куприн П.Е., и др. Хирургические технологии в лечении больных с метаболическим синдромом. // Вестник экспериментальной и клинической хирургии. — 2011. — Т. 4. — №2. — С. 247-251. [Fishman MB, Sedov VM, Kuprin PE, et al. Surgical technologies in treatment of patients with a metabolic syndrome. Vestnik eksperimental’noi i klinicheskoi khirurgii. 2011;4(2):247-251. (In Russ.)]Фишман М.Б., Седов В.М., Куприн П.Е., и др. Хирургические технологии в лечении больных с метаболическим синдромом. // Вестник экспериментальной и клинической хирургии. — 2011. — Т. 4. — №2. — С. 247-251. [Fishman MB, Sedov VM, Kuprin PE, et al. Surgical technologies in treatment of patients with a metabolic syndrome. Vestnik eksperimental’noi i klinicheskoi khirurgii. 2011;4(2):247-251. (In Russ.)]Nguyen NT, Huerta S, Gelfand D, et al. Bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2004;14(2):190-196. DOI:10.1381/096089204322857546Nguyen NT, Huerta S, Gelfand D, et al. Bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2004;14(2):190-196. DOI:10.1381/096089204322857546Husain S, Ahmed AR, Johnson J, et al. Small-bowel obstruction after laparoscopic Roux-en-Y gastric bypass: etiology, diagnosis, and management. Arch Surg. 2007;142(10):988-993. DOI:10.1001/archsurg.142.10.988Husain S, Ahmed AR, Johnson J, et al. Small-bowel obstruction after laparoscopic Roux-en-Y gastric bypass: etiology, diagnosis, and management. Arch Surg. 2007;142(10):988-993. DOI:10.1001/archsurg.142.10.988Koppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206(3):571-584. DOI:10.1016/j.jamcollsurg.2007.10.008Koppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206(3):571-584. DOI:10.1016/j.jamcollsurg.2007.10.008Rondelli F, Bugiantella W, Desio M, et al. Antecolic or Retrocolic Alimentary Limb in Laparoscopic Roux-en-Y Gastric Bypass? A Meta-Analysis. Obes Surg. 2016;26(1):182-195. DOI:10.1007/s11695-015-1918-xRondelli F, Bugiantella W, Desio M, et al. Antecolic or Retrocolic Alimentary Limb in Laparoscopic Roux-en-Y Gastric Bypass? A Meta-Analysis. Obes Surg. 2016;26(1):182-195. DOI:10.1007/s11695-015-1918-xNergaard BJ, Leifsson BG, Hedenbro J, Gislason H. Gastric bypass with long alimentary limb or long pancreato-biliary limb--long-term results on weight loss, resolution of co-morbidities and metabolic parameters. Obes Surg. 2014;24(10):1595-1602. DOI:10.1007/s11695-014-1245-7Nergaard BJ, Leifsson BG, Hedenbro J, Gislason H. Gastric bypass with long alimentary limb or long pancreato-biliary limb--long-term results on weight loss, resolution of co-morbidities and metabolic parameters. Obes Surg. 2014;24(10):1595-1602. DOI:10.1007/s11695-014-1245-7Юдин В.А., Мельников А.А., Мельникова И.А. Сравнение результатов хирургического лечения больных морбидным ожирением. // Анналы пластической, реконструктивной и эстетической хирургии. — 2015. — №4. — С. 68-76. [Yudin VA, Melnikov AA, Melnikova IA. Comparison of results 2 of surgical treatment of patients with morbid obesity. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii. 2015;(4):68-76. (In Russ.)]Юдин В.А., Мельников А.А., Мельникова И.А. Сравнение результатов хирургического лечения больных морбидным ожирением. // Анналы пластической, реконструктивной и эстетической хирургии. — 2015. — №4. — С. 68-76. [Yudin VA, Melnikov AA, Melnikova IA. Comparison of results 2 of surgical treatment of patients with morbid obesity. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii. 2015;(4):68-76. (In Russ.)]Berends F, Boerboom A, Aarts E, et al. A Longer Biliopancreatic Limb in Roux-en-Y Gastric Bypass Improves Weight Loss in the First Years After Surgery: Results of a Randomized Controlled Trial. Obes Surg. 2018;28(12):3744-3755. DOI:10.1007/s11695-018-3421-7Berends F, Boerboom A, Aarts E, et al. A Longer Biliopancreatic Limb in Roux-en-Y Gastric Bypass Improves Weight Loss in the First Years After Surgery: Results of a Randomized Controlled Trial. Obes Surg. 2018;28(12):3744-3755. DOI:10.1007/s11695-018-3421-7Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg. 2002;12(4):540-545. DOI:10.1381/096089202762252316Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg. 2002;12(4):540-545. DOI:10.1381/096089202762252316Pinheiro JS, Schiavon CA, Pereira PB, et al. Long-long limb Roux-en-Y gastric bypass is more efficacious in treatment of type 2 diabetes and lipid disorders in super-obese patients. Surg Obes Relat Dis. 2008;4(4):521-525; discussion 526-527. DOI:10.1016/j.soard.2007.12.016Pinheiro JS, Schiavon CA, Pereira PB, et al. Long-long limb Roux-en-Y gastric bypass is more efficacious in treatment of type 2 diabetes and lipid disorders in super-obese patients. Surg Obes Relat Dis. 2008;4(4):521-525; discussion 526-527. DOI:10.1016/j.soard.2007.12.016Navez B, Thomopoulos T, Stefanescu I, Coubeau L. Common Limb Length Does Not Influence Weight Loss After Standard Laparoscopic Roux-En-Y Gastric Bypass. Obes Surg. 2016;26(8):1705-1709. DOI:10.1007/s11695-015-1992-0Navez B, Thomopoulos T, Stefanescu I, Coubeau L. Common Limb Length Does Not Influence Weight Loss After Standard Laparoscopic Roux-En-Y Gastric Bypass. Obes Surg. 2016;26(8):1705-1709. DOI:10.1007/s11695-015-1992-0Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734-740. DOI:10.1097/01.sla.0000217592.04061.d5Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734-740. DOI:10.1097/01.sla.0000217592.04061.d5Fobi MA, Lee H, Igwe D, Jr., et al. Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Obes Surg. 2001;11(2):190-195. DOI:10.1381/096089201321577866Fobi MA, Lee H, Igwe D, Jr., et al. Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Obes Surg. 2001;11(2):190-195. DOI:10.1381/096089201321577866Sugerman H. Conversion of proximal to distal gastric bypass for failed gastric bypass for superobesity. J Gastrointest Surg. 1997;1(6):517-524. DOI:10.1016/s1091-255x(97)80067-4Sugerman H. Conversion of proximal to distal gastric bypass for failed gastric bypass for superobesity. J Gastrointest Surg. 1997;1(6):517-524. DOI:10.1016/s1091-255x(97)80067-4Savassi-Rocha AL, Diniz MTC, Savassi-Rocha PR, et al. Influence of Jejunoileal and Common Limb Length on Weight Loss Following Roux-en-Y Gastric Bypass. Obes Surg. 2008;18(11):1364-1368. DOI:10.1007/s11695-008-9475-1Savassi-Rocha AL, Diniz MTC, Savassi-Rocha PR, et al. Influence of Jejunoileal and Common Limb Length on Weight Loss Following Roux-en-Y Gastric Bypass. Obes Surg. 2008;18(11):1364-1368. DOI:10.1007/s11695-008-9475-1Swartz DE, Mobley E, Felix EL. Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain. Surg Obes Relat Dis. 2009;5(1):27-30. DOI:10.1016/j.soard.2008.10.009Swartz DE, Mobley E, Felix EL. Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain. Surg Obes Relat Dis. 2009;5(1):27-30. DOI:10.1016/j.soard.2008.10.009Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734-740. DOI:10.1097/01.sla.0000217592.04061.d5Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734-740. DOI:10.1097/01.sla.0000217592.04061.d5Orci L, Chilcott M, Huber O. Short versus long Roux-limb length in Roux-en-Y gastric bypass surgery for the treatment of morbid and super obesity: a systematic review of the literature. Obes Surg. 2011;21(6):797-804. DOI:10.1007/s11695-011-0409-yOrci L, Chilcott M, Huber O. Short versus long Roux-limb length in Roux-en-Y gastric bypass surgery for the treatment of morbid and super obesity: a systematic review of the literature. Obes Surg. 2011;21(6):797-804. DOI:10.1007/s11695-011-0409-yNelson WK, Fatima J, Houghton SG, et al. The malabsorptive very, very long limb Roux-en-Y gastric bypass for super obesity: results in 257 patients. Surgery. 2006;140(4):517-522, discussion 522-513. DOI:10.1016/j.surg.2006.06.020Nelson WK, Fatima J, Houghton SG, et al. The malabsorptive very, very long limb Roux-en-Y gastric bypass for super obesity: results in 257 patients. Surgery. 2006;140(4):517-522, discussion 522-513. DOI:10.1016/j.surg.2006.06.020Torres JC, Oca CF, Garrison RN. Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature. South Med J. 1983;76(10):1217-1221.Torres JC, Oca CF, Garrison RN. Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature. South Med J. 1983;76(10):1217-1221.Stubbs RS, Sarvepalli R. What makes a gastric bypass a good gastric bypass? Opinion and hypothesis. World J Surg Proced. 2014;4(2):48-54.Stubbs RS, Sarvepalli R. What makes a gastric bypass a good gastric bypass? Opinion and hypothesis. World J Surg Proced. 2014;4(2):48-54.Capella JF, Capella RF. An assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity. Am J Surg. 2002;183(2):117-123. DOI:10.1016/s0002-9610(01)00871-6Capella JF, Capella RF. An assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity. Am J Surg. 2002;183(2):117-123. DOI:10.1016/s0002-9610(01)00871-6White S, Brooks E, Jurikova L, Stubbs RS. Long-term outcomes after gastric bypass. Obes Surg. 2005;15(2):155-163. DOI:10.1381/0960892053268282White S, Brooks E, Jurikova L, Stubbs RS. Long-term outcomes after gastric bypass. Obes Surg. 2005;15(2):155-163. DOI:10.1381/0960892053268282Capella RF, Iannace VA, Capella JF. An analysis of gastric pouch anatomy in bariatric surgery. Obes Surg. 2008;18(7):782-790. DOI:10.1007/s11695-007-9303-zCapella RF, Iannace VA, Capella JF. An analysis of gastric pouch anatomy in bariatric surgery. Obes Surg. 2008;18(7):782-790. DOI:10.1007/s11695-007-9303-zFobi M. Why the Operation I Prefer is Silastic Ring Vertical Gastric Bypass. Obes Surg. 1991;1(4):423-426. DOI:10.1381/096089291765560854Fobi M. Why the Operation I Prefer is Silastic Ring Vertical Gastric Bypass. Obes Surg. 1991;1(4):423-426. DOI:10.1381/096089291765560854Stubbs RS, O’Brien I, Jurikova L. What ring size should be used in association with vertical gastric bypass? Obes Surg. 2006;16(10):1298-1303. DOI:10.1381/096089206778663661Stubbs RS, O’Brien I, Jurikova L. What ring size should be used in association with vertical gastric bypass? Obes Surg. 2006;16(10):1298-1303. DOI:10.1381/096089206778663661Fobi M, Conference ABSC. Banded gastric bypass: combining two principles. Surg Obes Relat Dis. 2005;1(3):304-309. DOI:10.1016/j.soard.2005.03.002Fobi M, Conference ABSC. Banded gastric bypass: combining two principles. Surg Obes Relat Dis. 2005;1(3):304-309. DOI:10.1016/j.soard.2005.03.002Capella RF, Capella JF, Mandec H, Nath P. Vertical Banded Gastroplasty-Gastric Bypass: preliminary report. Obes Surg. 1991;1(4):389-395. DOI:10.1381/096089291765560782Capella RF, Capella JF, Mandec H, Nath P. Vertical Banded Gastroplasty-Gastric Bypass: preliminary report. Obes Surg. 1991;1(4):389-395. DOI:10.1381/096089291765560782Fobi MA, Lee H. The surgical technique of the Fobi-Pouch operation for obesity (the transected silastic vertical gastric bypass). Obes Surg. 1998;8(3):283-288. DOI:10.1381/096089298765554485Fobi MA, Lee H. The surgical technique of the Fobi-Pouch operation for obesity (the transected silastic vertical gastric bypass). Obes Surg. 1998;8(3):283-288. DOI:10.1381/096089298765554485Dapri G, Cadiere GB, Himpens J. Laparoscopic placement of non-adjustable silicone ring for weight regain after Roux-en-Y gastric bypass. Obes Surg. 2009;19(5):650-654. DOI:10.1007/s11695-009-9807-9Dapri G, Cadiere GB, Himpens J. Laparoscopic placement of non-adjustable silicone ring for weight regain after Roux-en-Y gastric bypass. Obes Surg. 2009;19(5):650-654. DOI:10.1007/s11695-009-9807-9Bessler M, Daud A, DiGiorgi MF, et al. Adjustable gastric banding as a revisional bariatric procedure after failed gastric bypass. Obes Surg. 2005;15(10):1443-1448. DOI:10.1381/096089205774859173Bessler M, Daud A, DiGiorgi MF, et al. Adjustable gastric banding as a revisional bariatric procedure after failed gastric bypass. Obes Surg. 2005;15(10):1443-1448. DOI:10.1381/096089205774859173Dillemans B, Van Cauwenberge S, Agrawal S, et al. Laparoscopic adjustable banded roux-en-y gastric bypass as a primary procedure for the super-super-obese (body mass index > 60 kg/m(2)). BMC Surg. 2010;10:33. DOI:10.1186/1471-2482-10-33Dillemans B, Van Cauwenberge S, Agrawal S, et al. Laparoscopic adjustable banded roux-en-y gastric bypass as a primary procedure for the super-super-obese (body mass index > 60 kg/m(2)). BMC Surg. 2010;10:33. DOI:10.1186/1471-2482-10-33Arceo-Olaiz R, Espana-Gomez MN, Montalvo-Hernandez J, et al. Maximal weight loss after banded and unbanded laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial. Surg Obes Relat Dis. 2008;4(4):507-511. DOI:10.1016/j.soard.2007.11.006Arceo-Olaiz R, Espana-Gomez MN, Montalvo-Hernandez J, et al. Maximal weight loss after banded and unbanded laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial. Surg Obes Relat Dis. 2008;4(4):507-511. DOI:10.1016/j.soard.2007.11.006Gumbs AA, Margolis B, Bessler M. Laparoscopic banded-Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2006;2(3):408-409. DOI:10.1016/j.soard.2006.03.018Gumbs AA, Margolis B, Bessler M. Laparoscopic banded-Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2006;2(3):408-409. DOI:10.1016/j.soard.2006.03.018Lemmens L, Karcz WK, Bukhari W, et al. Banded gastric bypass - four years follow up in a prospective multicenter analysis. BMC Surg. 2014;14:88. DOI:10.1186/1471-2482-14-88Lemmens L, Karcz WK, Bukhari W, et al. Banded gastric bypass - four years follow up in a prospective multicenter analysis. BMC Surg. 2014;14:88. DOI:10.1186/1471-2482-14-88Karcz WKBT, Marjanovic G, Kuesters S. To have or not to have the ring: early and late surgical complications after banded Roux-en-Y gastric bypass. Wideochir Inne Tech Maloinwazyjne. 2008;3(2):53-65.Karcz WKBT, Marjanovic G, Kuesters S. To have or not to have the ring: early and late surgical complications after banded Roux-en-Y gastric bypass. Wideochir Inne Tech Maloinwazyjne. 2008;3(2):53-65.Fobi M, Lee H, Igwe D, et al. Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Obes Surg. 2001;11(6):699-707. DOI:10.1381/09608920160558632Fobi M, Lee H, Igwe D, et al. Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Obes Surg. 2001;11(6):699-707. DOI:10.1381/09608920160558632White S, Brooks E, Jurikova L, Stubbs RS. Long-term outcomes after gastric bypass. Obes Surg. 2005;15(2):155-163. DOI:10.1381/0960892053268282White S, Brooks E, Jurikova L, Stubbs RS. Long-term outcomes after gastric bypass. Obes Surg. 2005;15(2):155-163. DOI:10.1381/0960892053268282Himpens JM, Rogge F, Leman G, Sonneville T. Laparoscopic inflatable band with Roux-en-Y gastric bypass. Obes Surg. 2001;11(4):528-531. DOI:10.1381/096089201321209477Himpens JM, Rogge F, Leman G, Sonneville T. Laparoscopic inflatable band with Roux-en-Y gastric bypass. Obes Surg. 2001;11(4):528-531. DOI:10.1381/096089201321209477Greve JW, Furbetta F, Lesti G, et al. Combination of laparoscopic adjustable gastric banding and gastric bypass: current situation and future prospects -- routine use not advised. Obes Surg. 2004;14(5):683-689. DOI:10.1381/096089204323093499Greve JW, Furbetta F, Lesti G, et al. Combination of laparoscopic adjustable gastric banding and gastric bypass: current situation and future prospects -- routine use not advised. Obes Surg. 2004;14(5):683-689. DOI:10.1381/096089204323093499Ceelen W, Walder J, Cardon A, et al. Surgical treatment of severe obesity with a low-pressure adjustable gastric band: experimental data and clinical results in 625 patients. Ann Surg. 2003;237(1):10-16. DOI:10.1097/00000658-200301000-00002Ceelen W, Walder J, Cardon A, et al. Surgical treatment of severe obesity with a low-pressure adjustable gastric band: experimental data and clinical results in 625 patients. Ann Surg. 2003;237(1):10-16. DOI:10.1097/00000658-200301000-00002Musella M, Milone M. Still «controversies» about the mini gastric bypass? Obes Surg. 2014;24(4):643-644. DOI:10.1007/s11695-014-1193-2Musella M, Milone M. Still «controversies» about the mini gastric bypass? Obes Surg. 2014;24(4):643-644. DOI:10.1007/s11695-014-1193-2De Luca M, Tie T, Ooi G, et al. Mini Gastric Bypass-One Anastomosis Gastric Bypass (MGB-OAGB)-IFSO Position Statement. Obes Surg. 2018;28(5):1188-1206. DOI:10.1007/s11695-018-3182-3De Luca M, Tie T, Ooi G, et al. Mini Gastric Bypass-One Anastomosis Gastric Bypass (MGB-OAGB)-IFSO Position Statement. Obes Surg. 2018;28(5):1188-1206. DOI:10.1007/s11695-018-3182-3Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276-280. DOI:10.1381/096089201321336584Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276-280. DOI:10.1381/096089201321336584Rutledge R, Kular K, Manchanda N. The Mini-Gastric Bypass original technique. Int J Surg. 2019;61:38-41. DOI:10.1016/j.ijsu.2018.10.042Rutledge R, Kular K, Manchanda N. The Mini-Gastric Bypass original technique. Int J Surg. 2019;61:38-41. DOI:10.1016/j.ijsu.2018.10.042Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304-1308. DOI:10.1381/096089205774512663Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304-1308. DOI:10.1381/096089205774512663Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276-280. DOI:10.1381/096089201321336584Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276-280. DOI:10.1381/096089201321336584Deitel M, Hargroder D and Peraglie C. Mini-Gastric Bypass for Bariatric Surgery Increasing Worldwide. Austin J Surg. 2016;3(3):1092. doi: 10.26420/austinjsurg.2016.1092Deitel M, Hargroder D and Peraglie C. Mini-Gastric Bypass for Bariatric Surgery Increasing Worldwide. Austin J Surg. 2016;3(3):1092. doi: 10.26420/austinjsurg.2016.1092Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obes Surg. 2014;24(9):1430-1435. DOI:10.1007/s11695-014-1220-3Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obes Surg. 2014;24(9):1430-1435. DOI:10.1007/s11695-014-1220-3Lee WJ, Ser KH, Lee YC, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827-1834. DOI:10.1007/s11695-012-0726-9Lee WJ, Ser KH, Lee YC, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827-1834. DOI:10.1007/s11695-012-0726-9Rutledge R, Kular KS, Deitel M. Laparoscopic Mini-Gastric (One-Anastomosis) Bypass Surgery. In: Agrawal S, editor. Obesity, Bariatric and Metabolic Surgery. Cham: Springer; 2016. p. 415-423. DOI:10.1007/978-3-319-04343-2_43Rutledge R, Kular KS, Deitel M. Laparoscopic Mini-Gastric (One-Anastomosis) Bypass Surgery. In: Agrawal S, editor. Obesity, Bariatric and Metabolic Surgery. Cham: Springer; 2016. p. 415-423. DOI:10.1007/978-3-319-04343-2_43Carbajo MA, Luque-de-Leon E, Jimenez JM, et al. Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obes Surg. 2017;27(5):1153-1167. DOI:10.1007/s11695-016-2428-1Carbajo MA, Luque-de-Leon E, Jimenez JM, et al. Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obes Surg. 2017;27(5):1153-1167. DOI:10.1007/s11695-016-2428-1Carbajo M, Garcia-Caballero M, Toledano M, et al. One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005;15(3):398-404. DOI:10.1381/0960892053576677Carbajo M, Garcia-Caballero M, Toledano M, et al. One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005;15(3):398-404. DOI:10.1381/0960892053576677Carbajo MA, Luque-de-Leon E, Jimenez JM, et al. Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obes Surg. 2017;27(5):1153-1167. DOI:10.1007/s11695-016-2428-1Carbajo MA, Luque-de-Leon E, Jimenez JM, et al. Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obes Surg. 2017;27(5):1153-1167. DOI:10.1007/s11695-016-2428-1Fisher BL, Buchwald H, Clark W, et al. Mini-gastric bypass controversy. Obes Surg. 2001;11(6):773-777. DOI:10.1381/09608920160558777Fisher BL, Buchwald H, Clark W, et al. Mini-gastric bypass controversy. Obes Surg. 2001;11(6):773-777. DOI:10.1381/09608920160558777Mahawar KK, Kumar P, Carr WR, et al. Current status of mini-gastric bypass. J Minim Access Surg. 2016;12(4):305-310. DOI:10.4103/0972-9941.181352Mahawar KK, Kumar P, Carr WR, et al. Current status of mini-gastric bypass. J Minim Access Surg. 2016;12(4):305-310. DOI:10.4103/0972-9941.181352Pinheiro JS, Schiavon CA, Pereira PB, et al. Long-long limb Roux-en-Y gastric bypass is more efficacious in treatment of type 2 diabetes and lipid disorders in super-obese patients. Surg Obes Relat Dis. 2008;4(4):521-525; discussion 526-527. DOI:10.1016/j.soard.2007.12.016Pinheiro JS, Schiavon CA, Pereira PB, et al. Long-long limb Roux-en-Y gastric bypass is more efficacious in treatment of type 2 diabetes and lipid disorders in super-obese patients. Surg Obes Relat Dis. 2008;4(4):521-525; discussion 526-527. DOI:10.1016/j.soard.2007.12.016Iannelli A, Kassir R, Gugenheim J. The long and narrow gastric pouch for laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2014;24(10):1744-1745. DOI:10.1007/s11695-014-1378-8Iannelli A, Kassir R, Gugenheim J. The long and narrow gastric pouch for laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2014;24(10):1744-1745. DOI:10.1007/s11695-014-1378-8Himpens J, Leman G, Sonneville T. Laparoscopic Roux-en-Y gastric bypass performed without staples. Surg Endosc. 2004;19(7):1003. DOI:10.1007/s00464-004-2142-2Himpens J, Leman G, Sonneville T. Laparoscopic Roux-en-Y gastric bypass performed without staples. Surg Endosc. 2004;19(7):1003. DOI:10.1007/s00464-004-2142-2Himpens J, Leman G, Sonneville T. Laparoscopic Roux-en-Y gastric bypass performed without staples. Surg Endosc. 2005;19(7):1003. DOI:10.1007/s00464-004-2142-2Himpens J, Leman G, Sonneville T. Laparoscopic Roux-en-Y gastric bypass performed without staples. Surg Endosc. 2005;19(7):1003. DOI:10.1007/s00464-004-2142-2Ramos AC, Galvão M, Carlo A, et al. Staplerless lap gastric bypass. Obes Surg. 2005;15:1001(abst 271).Ramos AC, Galvão M, Carlo A, et al. Staplerless lap gastric bypass. Obes Surg. 2005;15:1001(abst 271).Ettinger JE, Ramos AC, Azaro E, et al. Staplerless laparoscopic gastric bypass: a new option in bariatric surgery. Obes Surg. 2006;16(5):638-645. DOI:10.1381/096089206776944896Ettinger JE, Ramos AC, Azaro E, et al. Staplerless laparoscopic gastric bypass: a new option in bariatric surgery. Obes Surg. 2006;16(5):638-645. DOI:10.1381/096089206776944896Ospanov O, Buchwald JN, Yeleuov G, Bekmurzinova F. Laparoscopic One-Anastomosis Gastric Bypass with Band-Separated Gastric Pouch (OAGB-BSGP): a Randomized Controlled Trial. Obes Surg. 2019;29(12):4131-4137. DOI:10.1007/s11695-019-04236-1Ospanov O, Buchwald JN, Yeleuov G, Bekmurzinova F. Laparoscopic One-Anastomosis Gastric Bypass with Band-Separated Gastric Pouch (OAGB-BSGP): a Randomized Controlled Trial. Obes Surg. 2019;29(12):4131-4137. DOI:10.1007/s11695-019-04236-1Ospanov OB. Surgical technique of laparoscopic mini-gastric bypass with obstructive stapleless pouch creation: A case series. Int J Surg. 2019;67:70-75. DOI:10.1016/j.ijsu.2019.05.011Ospanov OB. Surgical technique of laparoscopic mini-gastric bypass with obstructive stapleless pouch creation: A case series. Int J Surg. 2019;67:70-75. DOI:10.1016/j.ijsu.2019.05.011Ospanov O, Yeleuov G, Kadyrova I, Bekmurzinova F. The life expectancy of patients with metabolic syndrome after weight loss: study protocol for a randomized clinical trial (LIFEXPE-RT). Trials. 2019;20(1):202. DOI:10.1186/s13063-019-3304-9Ospanov O, Yeleuov G, Kadyrova I, Bekmurzinova F. The life expectancy of patients with metabolic syndrome after weight loss: study protocol for a randomized clinical trial (LIFEXPE-RT). Trials. 2019;20(1):202. DOI:10.1186/s13063-019-3304-9

The authors declare that there are no conflicts of interest present.