The Safety and Efficacy of Laparoscopic One Anastomosis Gastric Bypass as a Revision for Laparoscopic Adjustable Gastric Banding and Laparoscopic Sleeve Gastrectomy

Jun 15, 2025Obesity surgery

Safety and effectiveness of one-anastomosis gastric bypass surgery to revise adjustable gastric banding and sleeve gastrectomy

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Abstract

A total of 345 patients were reviewed for the safety and efficacy of revisional one anastomosis gastric bypass (OAGB).

The mean follow-up duration for patients was 11.6 months.
Preoperative body mass indexes (BMIs) were 43.0 for primary OAGB, 40.5 for OAGB after sleeve gastrectomy (Post LSG), and 42.9 for OAGB after adjustable gastric banding (Post LAGB).
Total weight loss percentage (TWL%) at 12 months was 34.76% for primary OAGB, 20.66% for Post LSG, and 30.23% for Post LAGB.
Late complications occurred in 9.5% of primary OAGB patients, 24% of Post LSG patients, and 12.3% of Post LAGB patients.
Revisional OAGB is associated with a slightly increased rate of complications and less weight loss compared to primary OAGB.

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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.

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The Safety and Efficacy of Laparoscopic One Anastomosis Gastric Bypass as a Revision for Laparoscopic Adjustable Gastric Banding and Laparoscopic Sleeve Gastrectomy

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