{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:28:43Z","timestamp":1792106923234,"version":"4.4.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Alexander Malthes Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The optimal surgical weight loss procedure for patients with a BMI of 50\u2009kg\/m2 or more is uncertain. This study compared distal Roux-en-Y gastric bypass (RYGB) with standard RYGB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this double-blind RCT, patients aged 18\u201360\u2009years with a BMI of 50\u201360\u2009kg\/m2 were allocated randomly to receive standard (150\u2009cm alimentary, 50\u2009cm biliopancreatic limb) or distal (150\u2009cm common channel, 50\u2009cm biliopancreatic limb) RYGB. The primary outcome (change in BMI at 2\u2009years) has been reported previously. Secondary outcomes 5\u2009years after surgery, such as weight loss, health-related quality of life, and nutritional outcomes are reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between May 2011 and April 2013, 123 patients were randomized, 113 received an intervention, and 92 attended 5-year follow-up. Mean age was 40 (95 per cent c.i. 38 to 41) years and 73 patients (65 per cent) were women; 57 underwent standard RYGB and 56 distal RYGB. BMI was reduced by 15.1 (95 per cent c.i. 13.9 to 16.2)\u2009kg\/m2 after standard and 15.7 (14.5 to 16.9)\u2009kg\/m2 after distal RYGB; the between-group difference was \u22120.64 (\u22122.3 to 1.0) kg\/m2 (P\u2009=\u20090.447). Total cholesterol, low-density lipoprotein cholesterol, and haemoglobin A1c levels declined more after distal than after standard RYGB. High-density lipoprotein cholesterol levels increased more after standard RYGB. Vitamin A and vitamin D levels were lower after distal RYGB. Changes in bone mineral density, resting metabolic rate, and total energy intake were comparable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Distal RYGB did not enable greater weight loss than standard RYGB. Differences in other outcomes favouring distal RYGB may not justify routine use of this procedure in patients with a BMI of 50\u201360\u2009kg\/m2. Registration number: NCT00821197 (http:\/\/www.clinicaltrials.gov).<\/jats:p>\n                  <jats:p>Presented in part as abstract to the IFSO (International Federation for the Surgery of Obesity and Metabolic disorders) conference, Madrid, Spain, August 2019.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrab105","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T11:09:34Z","timestamp":1632222574000},"source":"Crossref","is-referenced-by-count":14,"title":["Standard <i>versus<\/i> distal Roux-en-Y gastric bypass in patients with BMI 50\u201360 kg\/m2: 5-year outcomes of a double-blind, randomized clinical trial"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9437-3902","authenticated-orcid":false,"given":"Odd Bj\u00f8rn Kjeldaas","family":"Salte","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal and Paediatric Surgery, Oslo University Hospital, University of Oslo, 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