Long-term outcomes of revisional one anastomosis gastric bypass post laparoscopic sleeve gastrectomy

Jan 19, 2023Langenbeck's archives of surgery

Long-term results of revisional one-anastomosis gastric bypass after sleeve gastrectomy

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Abstract

A total of 29 patients underwent revisional one-anastomosis gastric bypass (OAGB) after laparoscopic sleeve gastrectomy (LSG).

Of the patients who underwent revisional OAGB, 89.7% were female.
Prior to LSG, the mean weight was 127.5 kg and the mean BMI was 49.0 kg/m.
The average weight loss after initial LSG was 43.8 kg, with a mean duration of 5.3 years before revisional OAGB.
The primary reasons for revision were weight regain (86.2%) and inadequate weight loss (13.8%).
Revisional OAGB resulted in %excess weight loss of 14.5% at 2 weeks and 54.7% at 5 years.
Twelve morbidities were reported during the follow-up period.

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PURPOSE: Revisional bariatric surgeries following laparoscopic sleeve gastrectomy (LSG) have demonstrated a dramatic increase worldwide. Recently, one-anastomosis gastric bypass (OAGB) has become a contender as an appropriate revisional procedure; however, no long-term data currently exist on the effectiveness of it as a revisional surgery post-LSG.

METHODS: A retrospective analysis was performed on all patients who underwent LSG at a public hospital in Kuwait from 2008 to 2017. A list was obtained of those who underwent revisional OAGB surgery after initial LSG, after which a phone survey was performed and demographics were analyzed.

RESULTS: A total of 29 patients underwent revisional OAGB post-initial LSG, of which 89.7% were female. Prior to LSG, the mean weight of the patients was 127.5 kg, and the mean BMI was 49.0 kg/m. The mean weight loss after initial LSG was 43.8 kg, while the average duration until patients underwent revisional OAGB was 5.3 years. The cause for revision was weight regain (86.2%) or inadequate weight loss (13.8%). Prior to undergoing revisional OAGB, the weight and BMI of the patients was 110.9 kg and 42.4 kg/m, respectively. Revisional OAGB demonstrated a %excess weight loss of 14.5%, 31.9%, 48.0%, 56.3%, 57.2%, and 54.7% at 2 weeks, 3 months, 6 months, 1 year, 4 years, and 5 years, respectively. Twelve morbidities were reported during the follow-up period. 2 2

CONCLUSION: Revisional bariatric surgery is technically demanding and may be associated with a high complication rate. However, OAGB as a revisional procedure has proven to be safe and effective in the long-term outcomes of revisional OAGB patients post-LSG.

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Long-term outcomes of revisional one anastomosis gastric bypass post laparoscopic sleeve gastrectomy

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