Roux‐en‐Y Versus One Anastomosis Gastric Bypass as Redo‐Operations Following Sleeve Gastrectomy: A Retrospective Study

Jan 5, 2022World journal of surgery

Comparing Two Types of Stomach Bypass Surgery as Follow-Up Operations After Sleeve Gastrectomy

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Abstract

A total of 123 patients underwent either Roux-en-Y gastric bypass (RYGB) or one anastomosis gastric bypass (OAGB) after sleeve gastrectomy.

Both RYGB and OAGB resulted in comparable total body weight loss of 18% after 12 months and 18% for RYGB and 23% for OAGB after 24 months.
Perioperative mortality was zero, and complication rates were not significantly different between the two procedures.
Mean surgery time was significantly shorter for OAGB at 168 minutes compared to 201 minutes for RYGB.
High remission rates were observed for arterial hypertension (89% for RYGB, 92% for OAGB) and Type 2 diabetes mellitus (100% for RYGB, 92% for OAGB).
The length of the individualized biliopancreatic limb was significantly correlated with total body weight loss.

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BACKGROUND: Aim of this study was to improve knowledge about the best conversional bariatric procedure following sleeve gastrectomy (SG).

METHODS: Data of conversional Roux-en-Y gastric bypass (RYGB) and of one anastomosis gastric bypass (OAGB) after SG were collected prospectively and analyzed retrospectively. Weight loss parameters, gastroesophageal reflux disease (GERD) and comorbidities outcomes were recorded.

RESULTS: Total of 123 patients (90 female, mean age 44 ± 0.9 years, mean body mass index (BMI) 42 ± 0.8 kg/m) had either RYGB (n = 68) or OAGB (n = 55). Perioperative mortality was zero. Mean surgery time was significantly shorter for OAGB (168 ± 7.2 vs. 201 ± 6.8 min). Perioperative complication rates were not significantly (ns) different between RYGB and OAGB. Total body weight loss (TBWL) in RYGB and OAGB was 18 ± 2.2% and 18 ± 1.9% (12 months) and 18 ± 3.0% and 23 ± 2.6% (24 months; ns), respectively. Length of (individualized) biliopancreatic limb (BPL) correlated significantly with weight loss. Remission rates after 12 months of RYGB and OAGB for arterial hypertension (aHt) were 89% and 92%, for obstructive sleep apnea (OSAS) 56% and 82%, for Type 2 diabetes mellitus (T2DM) 100% and 92%, for osteoarthritis 64% and 85% and for GERD 89% versus 87% (ns), respectively. Nutritional deficiencies were comparable in RYGB (n = 11) and OAGB (n = 14) group (ns). 2

CONCLUSION: Both RYGB and OAGB are effective conversional procedures after SG, leading to comparable TBWL, BMI-loss and high remission rates of comorbidities including GERD. Significantly shorter operation times were in favor of OAGB. BPL, which was longer in OAGB was significantly related to higher %TBWL and %BMI-loss compared to RYGB.

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Roux‐en‐Y Versus One Anastomosis Gastric Bypass as Redo‐Operations Following Sleeve Gastrectomy: A Retrospective Study

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