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The length of the biliopancreatic limb (BPL) is a key determinant of weight loss and metabolic effect, but excessively long limbs may predispose to malabsorptive complications. Long-term outcome data for fixed long BPLs remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate long-term severe complications requiring revisional surgery following OAGB with a fixed biliopancreatic limb length of 250 cm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre retrospective cohort study included all consecutive patients who underwent primary OAGB with a 250-cm BPL between 2010 and 2020. Data were extracted from hospital electronic and paper records. Patients were invited for a structured clinical and biochemical assessment. Severe complications were predefined and reviewed by a multidisciplinary team. Outcomes of interest were severe complications requiring revisional surgery. Follow-up ranged from 7 to 15 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 892 OAGB procedures performed during the study period, 97 patients (10.9%) underwent OAGB with a 250-cm BPL. Complete follow-up data were available for 78 patients (80.4%). Mean age was 47 years, mean preoperative BMI was 46.6 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , and 75.3% were female. Nineteen patients (24.3%) developed severe complications requiring revisional surgery. Indications included severe protein malnutrition (5.1%), refractory bile or acid reflux (6.4%), severe diarrhoea (6.4%), liver failure (2.5%), twisted gastrojejunostomy (2.5%), and excessive weight loss (1.3%). Revisions included conversion to sleeve gastrectomy, Roux-en-Y gastric bypass, or reversal to normal anatomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OAGB with a fixed biliopancreatic limb length of 250 cm was associated with a high rate of severe long-term complications requiring revisional surgery. These findings support cautious tailoring of BPL length and avoidance of routinely long limbs in OAGB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08869-x","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T07:49:39Z","timestamp":1784965779000},"page":"4766-4775","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Revisions of One Anastomosis Gastric Bypass with Biliopancreatic Limb of 250\u2009cm Multicentre Retrospective Study with a Mean Follow-up of 11 years"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9956-0291","authenticated-orcid":false,"given":"ABDULZAHRA","family":"Hussain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"AlWadees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"AL Hakkak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer","family":"Habeeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vasas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"issue":"3","key":"8869_CR1","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1381\/096089201321336584","volume":"11","author":"R Rutledge","year":"2001","unstructured":"Rutledge R. 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