One Anastomosis Gastric Bypass for Revisional Bariatric Surgery: Assessment of Short-Term Safety

May 16, 2023Obesity surgery

Short-Term Safety of One Anastomosis Gastric Bypass Used to Redo Weight Loss Surgery

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Abstract

A total of 82 patients were included, with 41 undergoing conversion to one anastomosis gastric bypass (OAGB) and 41 to Roux-en-Y gastric bypass (RYGB).

Both groups primarily consisted of patients converting from sleeve gastrectomy (71% OAGB vs. 78% RYGB).
Operative time, estimated blood loss, and hospital length of stay were similar between OAGB and RYGB.
30-day complication rates were comparable at 9.8% for OAGB and 12.2% for RYGB.
Reoperation rates were identical at 4.9% for both OAGB and RYGB.
Mean weight loss at 1 month was similar, with OAGB patients losing 7.91 lbs and RYGB patients losing 6.36 lbs.

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PURPOSE: With the continued increase in bariatric procedures being performed in the USA, a growing percentage are revisions for weight regain after sleeve gastrectomy (SG) and gastric banding (LAGB). Standard practice in the USA involves conversion to Roux-en-Y gastric bypass (RYGB). Internationally, one anastomosis gastric bypass (OAGB) has become a popular and effective alternative. Without the jejuno-jejunal anastomosis, OAGB has reduced potential related long-term complications. The purpose of this study is to compare the short-term safety of revision to OAGB versus RYGB.

MATERIALS AND METHODS: Patients who underwent conversion to OAGB from LAGB or SG for weight regain from January 2019 to October 2021 were compared to BMI, sex, and age-matched patients who underwent conversion to RYGB.

RESULTS: In our study, 82 patients were included, 41 in each cohort (41 OAGB vs. 41 RYGB). The majority in both groups underwent conversion from SG (71% vs. 78%). Operative time, estimated blood loss, and length of stay were comparable. There was no difference in 30-day complications (9.8% vs. 12.2%, p = .99) or reoperation (4.9% vs. 4.9%, p = .99). Mean weight loss at 1 month was also comparable (7.91 lbs vs 6.36 lbs).

CONCLUSIONS: Patients undergoing conversion to OAGB for weight regain had similar operative times, post-operative complication rates, and 1-month weight loss compared to those who underwent RYGB. While more research is needed, this early data suggests that OAGB and RYGB provide comparable outcomes when used as conversion procedures for to failed weight loss. Therefore, OAGB may present a safe alternative to RYGB.

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One Anastomosis Gastric Bypass for Revisional Bariatric Surgery: Assessment of Short-Term Safety

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