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

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Abstract

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/m2. 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/m2, 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.

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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References

  1. Alalwan AA, Friedman J, Park H, Segal R, Brumback BA, Hartzema AG (2021) US national trends in bariatric surgery: a decade of study. Surgery 170(1):13–17

    Article  PubMed  Google Scholar 

  2. Khorgami Z, Shoar S, Andalib A, Aminian A, Brethauer SA, Schauer PR (2017) Trends in utilization of bariatric surgery, 2010–2014: sleeve gastrectomy dominates. Surg Obes Relat Dis 13(5):774–778

    Article  PubMed  Google Scholar 

  3. Prevalence of overweight among adults, BMI ≥ 25, age-standardized Estimates by WHO Region: WHO; 2017.  http://apps.who.int/gho/data/view.main.GLOBAL2461A?lang=en. Accessed May 2022

  4. Lehnert T, Sonntag D, Konnopka A, Riedel-Heller S, Konig HH (2013) Economic costs of overweight and obesity. Best Pract Res Clin Endocrinol Metab 27(2):105–115

    Article  PubMed  Google Scholar 

  5. Prospective Studies C, Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J et al (2009) Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet 373(9669):1083–1096

    Article  Google Scholar 

  6. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371(9612):569–578

    Article  PubMed  Google Scholar 

  7. Deitel M, Gagner M, Erickson AL, Crosby RD (2011) Third international summit: current status of sleeve gastrectomy. Surg Obes Relat Dis 7(6):749–759

    Article  PubMed  Google Scholar 

  8. Silecchia G, De Angelis F, Rizzello M, Albanese A, Longo F, Foletto M (2015) Residual fundus or neofundus after laparoscopic sleeve gastrectomy: is fundectomy safe and effective as revision surgery? Surg Endosc 29(10):2899–2903

    Article  PubMed  Google Scholar 

  9. Homan J, Betzel B, Aarts EO, van Laarhoven KJ, Janssen IM, Berends FJ (2015) Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis 11(4):771–777

    Article  PubMed  Google Scholar 

  10. Slegtenhorst BR, van der Harst E, Demirkiran A, de Korte J, Schelfhout LJ, Klaassen RA (2013) Effect of primary versus revisional Roux-en-Y gastric bypass: inferior weight loss of revisional surgery after gastric banding. Surg Obes Relat Dis 9(2):253–258

    Article  PubMed  Google Scholar 

  11. Zingg U, McQuinn A, DiValentino D, Kinsey-Trotman S, Game P, Watson D. Revisional vs. primary Roux-en-Y gastric bypass--a case-matched analysis: less weight loss in revisions. Obes Surg. 2010;20(12):1627–32.

  12. Al-Sabah S, Al Haddad E, Akrof S, Alenezi K, Al-Subaie S (2020) Midterm results of revisional bariatric surgery postsleeve gastrectomy: resleeve versus bypass. Surg Obes Relat Dis 16(11):1747–1756

    Article  PubMed  Google Scholar 

  13. Thereaux J, Corigliano N, Poitou C, Oppert JM, Czernichow S, Bouillot JL (2015) Five-year weight loss in primary gastric bypass and revisional gastric bypass for failed adjustable gastric banding: results of a case-matched study. Surg Obes Relat Dis 11(1):19–25

    Article  PubMed  Google Scholar 

  14. Mor A, Keenan E, Portenier D, Torquati A (2013) Case-matched analysis comparing outcomes of revisional versus primary laparoscopic Roux-en-Y gastric bypass. Surg Endosc 27(2):548–552

    Article  PubMed  Google Scholar 

  15. Topart P, Becouarn G, Ritz P (2009) One-year weight loss after primary or revisional Roux-en-Y gastric bypass for failed adjustable gastric banding. Surg Obes Relat Dis 5(4):459–462

    Article  PubMed  Google Scholar 

  16. Georgiadou D, Sergentanis TN, Nixon A, Diamantis T, Tsigris C, Psaltopoulou T (2014) Efficacy and safety of laparoscopic mini gastric bypass. A systematic review. Surg Obes Relat Dis 10(5):984–91

  17. Jammu GS, Sharma R (2016) A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-En-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg 26(5):926–932

    Article  PubMed  Google Scholar 

  18. Kular KS, Manchanda N, Rutledge R (2014) A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obes Surg 24(9):1430–1435

    Article  CAS  PubMed  Google Scholar 

  19. Rutledge R, Walsh TR (2005) Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg 15(9):1304–1308

    Article  PubMed  Google Scholar 

  20. Chevallier JM, Chakhtoura G, Zinzindohoue F (2009) Laparoscopic mini-gastric bypass. J Chir (Paris) 146(1):60–64

    Article  PubMed  Google Scholar 

  21. Vitiello A, Berardi G, Velotti N, De Palma GD, Musella M (2021) Is there an indication left for gastric band? A single center experience on 178 patients with a follow-up of 10 years. Updates Surg 73(2):657–662

    Article  PubMed  Google Scholar 

  22. Lauti M, Kularatna M, Hill AG, MacCormick AD (2016) Weight regain following sleeve gastrectomy-a systematic review. Obes Surg 26(6):1326–1334

    Article  PubMed  Google Scholar 

  23. Felsenreich DM, Langer FB, Kefurt R, Panhofer P, Schermann M, Beckerhinn P et al (2016) Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 12(9):1655–1662

    Article  PubMed  Google Scholar 

  24. De Luca M, Tie T, Ooi G, Higa K, Himpens J, Carbajo MA et al (2018) Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg 28(5):1188–1206

    Article  PubMed  Google Scholar 

  25. Kermansaravi M, Shahmiri SS, DavarpanahJazi AH, Valizadeh R, Berardi G, Vitiello A et al (2021) One anastomosis/mini-gastric bypass (OAGB/MGB) as revisional surgery following primary restrictive bariatric procedures: a systematic review and meta-analysis. Obes Surg 31(1):370–383

    Article  PubMed  Google Scholar 

  26. Jamal MH, Elabd R, AlMutairi R, Albraheem A, Alhaj A, Alkhayat H et al (2020) The safety and efficacy of one anastomosis gastric bypass as a revision for sleeve gastrectomy. Obes Surg 30(6):2280–2284

    Article  PubMed  Google Scholar 

  27. Robert M, Espalieu P, Pelascini E, Caiazzo R, Sterkers A, Khamphommala L et al (2019) Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. The Lancet 393(10178):1299–1309

    Article  Google Scholar 

  28. Van Wieren IA, Thumma JR, Obeid NR, Varban OA, Dimick JB (2019) The influence of gastroesophageal reflux symptoms on patient satisfaction after sleeve gastrectomy. Surgery 166(5):873–878

    Article  PubMed  Google Scholar 

  29. Lee S, Carmody B, Wolfe L, DeMaria E, Kellum JM, Sugerman H et al (2007) Effect of location and speed of diagnosis on anastomotic leak outcomes in 3828 gastric bypass cases. J Gastrointest Surg 11(6):708–713

    Article  PubMed  Google Scholar 

  30. Facchiano E, Iannelli A, Lucchese M (2016) Internal hernia after mini-gastric bypass: myth or reality? J Visc Surg 153(3):231–232

    Article  CAS  PubMed  Google Scholar 

  31. Parmar CD, Mahawar KK (2018) One anastomosis (mini) gastric bypass is now an established bariatric procedure: a systematic review of 12,807 patients. Obes Surg 28(9):2956–2967

    Article  PubMed  Google Scholar 

  32. Velanovich V (2007) The development of the GERD-HRQL symptom severity instrument. Dis Esophagus 20(2):130–134

    Article  CAS  PubMed  Google Scholar 

  33. AlSabah S, Alsharqawi N, Almulla A, Akrof S, Alenezi K, Buhaimed W, et al. (2016) Approach to poor weight loss after laparoscopic sleeve gastrectomy: re-sleeve vs. gastric bypass. Obes Surg 26(10):2302–7

  34. Shirazi N, Beglaibter N, Grinbaum R, Ahmad WA, Aronis A (2022) Nutritional outcomes one year after one anastomosis gastric bypass compared to sleeve gastrectomy. Nutrients 14(13)

  35. Nabil TM, Khalil AH, Mikhail S, Soliman SS, Aziz M, Antoine H (2019) Conventional versus distal laparoscopic one-anastomosis gastric bypass: a randomized controlled trial with 1-year follow-up. Obes Surg 29(10):3103–3110

    Article  PubMed  Google Scholar 

  36. Pizza F, Lucido FS, D’Antonio D, Tolone S, Gambardella C, Dell’Isola C et al (2020) Biliopancreatic limb length in one anastomosis gastric bypass: which is the best? Obes Surg 30(10):3685–3694

    Article  PubMed  Google Scholar 

  37. Khalaj A, Kalantar Motamedi MA, Mousapour P, Valizadeh M, Barzin M (2019) Protein-calorie malnutrition requiring revisional surgery after one-anastomosis-mini-gastric bypass (OAGB-MGB): case series from the tehran obesity treatment study (TOTS). Obes Surg 29(6):1714–1720

    Article  PubMed  Google Scholar 

  38. Motamedi MAK, Barzin M, Ebrahimi M, Ebrahimi R, Khalaj A (2017) Severe fatal protein malnutrition and liver failure in a morbidly obese patient after mini-gastric bypass surgery: case report. Int J Surg Case Rep 33:71–74

    Article  PubMed  PubMed Central  Google Scholar 

  39. Haddad A, Bashir A, Fobi M, Higa K, Herrera MF, Torres AJ et al (2021) The IFSO worldwide one anastomosis gastric bypass survey: techniques and outcomes? Obes Surg 31(4):1411–1421

    Article  PubMed  Google Scholar 

  40. Al-Mutawa A, Al-Sabah S, Anderson AK, Al-Mutawa M (2018) Evaluation of nutritional status post laparoscopic sleeve gastrectomy-5-year outcomes. Obes Surg 28(6):1473–1483

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Kuwait University, Kuwait City, Kuwait

    Salman AlSabah

  2. Al Amiri Hospital, Kuwait City, Kuwait

    Eliana Al Haddad, Saud Al-Subaie, Shehab Ekrouf, Ahmad Almulla, Mohannad Alhaddad, Mais Shiekh Aljabal & Khaled Alenezi

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  1. Salman AlSabah
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  2. Eliana Al Haddad
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  3. Saud Al-Subaie
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  4. Shehab Ekrouf
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  5. Ahmad Almulla
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  6. Mohannad Alhaddad
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  7. Mais Shiekh Aljabal
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  8. Khaled Alenezi
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Contributions

SA conceptualized the idea and brought together all the authors, as well as proof read and edited the manuscript. SASS, SE, MA, KA, and AA performed the surgeries and contributed to the collection of data. MSA collected the data from the hospitals and contributed to the writing of the manuscript. EA analyzed the data and wrote and edited the manuscript. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Salman AlSabah.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare no competing interests.

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AlSabah, S., Al Haddad, E., Al-Subaie, S. et al. Long-term outcomes of revisional one anastomosis gastric bypass post laparoscopic sleeve gastrectomy. Langenbecks Arch Surg 408, 43 (2023). https://doi.org/10.1007/s00423-023-02787-7

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