INTRODUCTION: Laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) have been prominent bariatric surgeries in recent years. Despite their initial success, long-term outcomes indicate that a subset of patients experience weight gain recurrence or complications necessitating a secondary procedure. One anastomosis gastric bypass (OAGB) has emerged as a potential option for such revisional surgeries.
OBJECTIVES: This study aims to assess the safety and efficacy of revisional OAGB following LSG and LAGB procedures.
METHODS: Medical records of patients who underwent OAGB surgery between May 2016 and July 2020 were reviewed. Patients were categorized into three groups: primary OAGB, OAGB after LSG (Post LSG), and OAGB after LAGB (Post LAGB). Post-operative complications, body mass index (BMI), the percentage of total weight loss (TWL%), and excess BMI loss percentage (%EBMIL) were compared across these groups.
RESULTS: A total of 345 patients were included, with 230 undergoing primary OAGB, 70 transitioning from LSG to OAGB, and 45 from LAGB to OAGB. The mean follow-up duration was 11.6 months. Preoperative BMIs were 43.0 ± 6.3, 40.5 ± 6.7, and 42.9 ± 6.6 for primary OAGB, Post LSG, and Post LAGB, respectively. TWL% at 12 months was 34.76% for primary OAGB, 20.66% for Post LSG, and 30.23% for Post LAGB. Late complications (> 30 days) occurred at rates of 9.5%, 24%, and 12.3% respectively.
CONCLUSION: These findings indicate that revisional OAGB following LSG and LAGB is both safe and effective; however, it involves a slightly increased rate of complications and less pronounced weight loss compared to primary OAGB.
