Conversion from laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) to one anastomosis gastric bypass (OAGB): preliminary data from a multicenter retrospective study

Jul 6, 2019Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Early results on switching from adjustable stomach banding or sleeve surgery to one anastomosis gastric bypass

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Abstract

Three hundred patients underwent conversion to one anastomosis gastric bypass (OAGB) after prior bariatric surgeries.

Body mass index (BMI) decreased from 45.1 kg/m² at the time of the first intervention to 30.5 kg/m² at the last follow-up.
The mean percentage of excess BMI loss increased from 13.2% at conversion to 73.4% after OAGB.
Remission rates for co-morbidities included 40% for hypertension, 62.5% for diabetes, 58.7% for gastroesophageal reflux, and 52% for dyslipidemia.
Mean follow-up duration was 20.8 months, with an overall complications rate of 8.6%.
OAGB may be considered a safe and effective option for patients who failed previous restrictive bariatric surgeries.

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BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure, while laparoscopic adjustable gastric banding (LAGB) has been for a decade one of the most popular interventions for weight loss. After LSG and LAGB, some patients may require a second surgery due to weight regain or late complications. One anastomosis gastric bypass (OAGB) is a promising bariatric procedure, which provides effective long-term weight loss and has a favorable effect on type 2 diabetes.

OBJECTIVES: To retrospectively analyze data from 10 Italian centers on conversion from LAGB and LSG to OAGB.

SETTING: High-volume centers for bariatric surgery.

METHODS: Prospectively collected data from 10 high-volume centers were retrospectively reviewed. Body mass index (BMI), percentage of excess BMI loss, reasons for redo, remission from co-morbidities (hypertension, diabetes, gastroesophageal reflux, and dyslipidemia), and major complications were recorded.

RESULTS: Three hundred patients were included in the study; 196 patients underwent conversion from LAGB to OAGB and 104 were converted from LSG. BMI was 45.1 ± 7 kg/mat the time of first intervention, 41.8 ± 6.3 kg/mat redo time, and 30.5 ± 5.5 kg/mat last follow-up appointment. Mean percentage of excess BMI loss was 13.2 ± 28.2 at conversion and 73.4 ± 27.5 after OAGB. Remission rates from hypertension, diabetes, gastroesophageal reflux, and dyslipidemia were 40%, 62.5%, 58.7% and 52%, respectively. Mean follow-up was 20.8 (range, 6-156) months and overall complications rate was 8.6%. 2 2 2

CONCLUSION: Our data show that OAGB is a safe and effective revisional procedure after failed restrictive bariatric surgery.

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Conversion from laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) to one anastomosis gastric bypass (OAGB): preliminary data from a multicenter retrospective study

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