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One Anastomosis Gastric Bypass for Revisional Bariatric Surgery: Assessment of Short-Term Safety

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Abstract

Purpose

With the continued increase in bariatric procedures being performed in the USA, a growing percentage are revisions for weight regain after sleeve gastrectomy (SG) and gastric banding (LAGB). Standard practice in the USA involves conversion to Roux-en-Y gastric bypass (RYGB). Internationally, one anastomosis gastric bypass (OAGB) has become a popular and effective alternative. Without the jejuno-jejunal anastomosis, OAGB has reduced potential related long-term complications. The purpose of this study is to compare the short-term safety of revision to OAGB versus RYGB.

Materials and Methods

Patients who underwent conversion to OAGB from LAGB or SG for weight regain from January 2019 to October 2021 were compared to BMI, sex, and age-matched patients who underwent conversion to RYGB.

Results

In our study, 82 patients were included, 41 in each cohort (41 OAGB vs. 41 RYGB). The majority in both groups underwent conversion from SG (71% vs. 78%). Operative time, estimated blood loss, and length of stay were comparable. There was no difference in 30-day complications (9.8% vs. 12.2%, p = .99) or reoperation (4.9% vs. 4.9%, p = .99). Mean weight loss at 1 month was also comparable (7.91 lbs vs 6.36 lbs).

Conclusions

Patients undergoing conversion to OAGB for weight regain had similar operative times, post-operative complication rates, and 1-month weight loss compared to those who underwent RYGB. While more research is needed, this early data suggests that OAGB and RYGB provide comparable outcomes when used as conversion procedures for to failed weight loss. Therefore, OAGB may present a safe alternative to RYGB.

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References

  1. Varela JE, Nguyen NT. Laparoscopic sleeve gastrectomy leads the U.S. utilization of bariatric surgery at academic medical centers. Surg Obes Relat Dis. 2015;11(5):987–90. https://doi.org/10.1016/j.soard.2015.02.008. Epub 2015 Feb 12. Erratum in: Surg Obes Relat Dis. 2016;(4):937. Esteban Varela, J [corrected to Varela, J Esteban]

    Article  PubMed  Google Scholar 

  2. Liu SYW, Wong SKH, Lam CCH, et al. Long-term results on weight loss and diabetes redmission after laparoscopic sleeve gas- trectomy for a morbidly obese Chinese population. Obes Surg. 2015;25(10):1901–8.

    Article  CAS  PubMed  Google Scholar 

  3. Carmeli I, Golomb I, Sadot E, et al. Laparoscopic conversion of sleeve gastrectomy to a biliopancreatic diversion with duodenal switch or a roux-en-Y gastric bypass due to weight loss failure: our algorithm. Surg Obes Relat Dis. 2015;11(1):79–85.

    Article  PubMed  Google Scholar 

  4. Vitiello A, Berardi G, Velotti N, De Palma GD, Musella M. Is there an indication left for gastric band? A single center experience on 178 patients with a follow-up of 10 years. Updat Surg. 2021;73(2):657–62. https://doi.org/10.1007/s13304-020-00858-8.

  5. Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276–80.

    Article  CAS  PubMed  Google Scholar 

  6. Carbajo M, García-Caballero M, Toledano M, et al. One- anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005;15(3):398–404.

    Article  PubMed  Google Scholar 

  7. Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1, 054 mini-gastric bypasses—first study from Indian subcontinent. Obes Surg. 2014;24:1430–5.

    Article  CAS  PubMed  Google Scholar 

  8. AlSabah S, Al Haddad E, Al-Subaie S, Ekrouf S, Alenezi K, Almulla A, Alhaddad M. Short-term results of revisional single-anastomosis gastric bypass after sleeve gastrectomy for weight regain. Obes Surg. 2018;28(8):2197–202. https://doi.org/10.1007/s11695-018-3158-3.

    Article  PubMed  Google Scholar 

  9. Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases com- paring sleeve gastrectomy, roux-en-Y gastric bypass and mini- gastric bypass, to determine an effective and safe bariatric and met- abolic procedure. Obes Surg. 2015;26:926–32.

    Article  Google Scholar 

  10. Jamal MH, Elabd R, AlMutairi R, Albraheem A, Alhaj A, Alkhayat H, AlHarbi O, Almahmeed H. The safety and efficacy of one anastomosis gastric bypass as a revision for sleeve gastrectomy. Obes Surg. 2020;30(6):2280–4. https://doi.org/10.1007/s11695-020-04484-6.

    Article  PubMed  Google Scholar 

  11. Kassir R, Petrucciani N, Debs T, Juglard G, Martini F, Liagre A. Conversion of one anastomosis gastric bypass (OAGB) to Roux-en-Y gastric bypass (RYGB) for biliary reflux resistant to medical treatment: lessons learned from a retrospective series of 2780 consecutive patients undergoing OAGB. Obes Surg. 2020;30(6):2093–8. https://doi.org/10.1007/s11695-020-04460-0.

    Article  PubMed  Google Scholar 

  12. Parmar CD, Gan J, Stier C, Dong Z, Chiappetta S, El-Kadre L, Bashah MM, Wang C, Sakran N. One anastomosis/mini gastric bypass (OAGB-MGB) as revisional bariatric surgery after failed primary adjustable gastric band (LAGB) and sleeve gastrectomy (SG): A systematic review of 1075 patients. Int J Surg. 2020;81:32–8. https://doi.org/10.1016/j.ijsu.2020.07.007. 

  13. Petrucciani N, Martini F, Benois M, Kassir R, Boudrie H, Van Haverbeke O, Hamid C, Juglard G, Costa G, Debs T, Liagre A. Revisional one anastomosis gastric bypass with a 150-cm biliopancreatic limb after failure of adjustable gastric banding: mid-term outcomes and comparison between one- and two-stage approaches. Obes Surg. 2021;31(12):5330–41. https://doi.org/10.1007/s11695-021-05728-9.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jia D, Tan H, Faramand A, Fang F. One anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity: a systematic review and meta-analysis of randomized clinical trials. Obes Surg. 2020;30(4):1211–8. https://doi.org/10.1007/s11695-019-04288-3.

    Article  PubMed  Google Scholar 

  15. De Luca M, Tie T, Ooi G, Higa K, Himpens J, Carbajo MA, Mahawar K, Shikora S, Brown WA. Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg. 2018;28(5):1188–206. https://doi.org/10.1007/s11695-018-3182-3.

    Article  PubMed  Google Scholar 

  16. Kermansaravi M, Parmar C, Chiappetta S, Shahabi S, Abbass A, Abbas SI, Abouzeid M, Antozzi L, Asghar ST, Bashir A, Bhandari M, Billy H, Caina D, Campos FJ, Carbajo MA, Chevallier JM, Jazi AHD, de Gordejuela AGR, Haddad A, et al. Patient selection in one anastomosis/mini gastric bypass-an expert modified Delphi consensus. Obes Surg. 2022;32(8):2512–24. https://doi.org/10.1007/s11695-022-06124-7.

  17. Parikh M, Eisenberg D, Johnson J. El-Chaar M; American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery review of the literature on one-anastomosis gastric bypass. Surg Obes Relat Dis. 2018;14(8):1088–92. https://doi.org/10.1016/j.soard.2018.04.017. 

  18. Liagre A, Martini F, Kassir R, Juglard G, Hamid C, Boudrie H, Van Haverbeke O, Antolino L, Debs T, Petrucciani N. Is one anastomosis gastric bypass with a biliopancreatic limb of 150 cm effective in the treatment of people with severe obesity with BMI > 50? Obes Surg. 2021;31(9):3966–74. https://doi.org/10.1007/s11695-021-05499-3. 

  19. Khrucharoen U, Juo YY, Chen Y, Dutson EP. Indications, operative techniques, and outcomes for revisional operation following mini-gastric bypass-one anastomosis gastric bypass: a systematic review. Obes Surg. 2020;30(4):1564–73. https://doi.org/10.1007/s11695-019-04276-7.

    Article  PubMed  Google Scholar 

  20. Liagre A, Kassir R, Debs T, Petrucciani N. One anastomosis gastric bypass with an afferent limb of 150 cm and postoperative reflux. Obes Surg. 2020;30(7):2810–1. https://doi.org/10.1007/s11695-020-04595-0.

    Article  PubMed  Google Scholar 

  21. Level L, Rojas A, Piñango S, Avariano Y. One anastomosis gastric bypass vs. Roux-en-Y gastric bypass: a 5-year follow-up prospective randomized trial. Langenbeck's Arch Surg. 2021;406(1):171–9. https://doi.org/10.1007/s00423-020-01949-1. 

  22. Magouliotis DE, Tasiopoulou VS, Tzovaras G. One anastomosis gastric bypass versus Roux-en-Y gastric bypass for morbid obesity: a meta-analysis. Clin Obes. 2018;8(3):159–69. https://doi.org/10.1111/cob.12246. Epub 2018 Mar 24

    Article  CAS  PubMed  Google Scholar 

  23. Velotti N, Vitiello A, Berardi G, Di Lauro K, Musella M. Roux-en-Y gastric bypass versus one anastomosis-mini gastric bypass as a rescue procedure following failed restrictive bariatric surgery. A systematic review of literature with metanalysis. Updat Surg. 2021;73(2):639–47. https://doi.org/10.1007/s13304-020-00938-9.

  24. Csendes A. Bile reflux after one anastomosis gastric bypass. Obes Surg. 2020;30(7):2802–3. https://doi.org/10.1007/s11695-020-04567-4.

    Article  PubMed  Google Scholar 

  25. Magouliotis DE, Tasiopoulou VS, Svokos AA, Svokos KA, Sioka E, Zacharoulis D. One-anastomosis gastric bypass versus sleeve gastrectomy for morbid obesity: a systematic review and meta-analysis. Obes Surg. 2017;27(9):2479–87. https://doi.org/10.1007/s11695-017-2807-2.

    Article  PubMed  Google Scholar 

  26. Kessler Y, Adelson D, Mardy-Tilbor L, Ben-Porat T, Szold A, Goitein D, Sakran N, Raziel A, Sherf-Dagan S. Nutritional status following one anastomosis gastric bypass. Clin Nutr. 2020;39(2):599–605. https://doi.org/10.1016/j.clnu.2019.03.008.

  27. Haddad A, Bashir A, Fobi M, Higa K, Herrera MF, Torres AJ, Himpens J, Shikora S, Ramos AC, Kow L, Nimeri AA. The IFSO worldwide one anastomosis gastric bypass survey: techniques and outcomes? Obes Surg. 2021;31(4):1411–21. https://doi.org/10.1007/s11695-021-05249-5.

  28. Kermansaravi M, Shahmiri SS, Davarpanah Jazi AH, Valizadeh R, Weiner RA, Chiappetta S. Reversal to normal anatomy after one-anastomosis/mini gastric bypass, indications and results: a systematic review and meta-analysis. Surg Obes Relat Dis. 2021;17(8):1489–96. https://doi.org/10.1016/j.soard.2021.04.013.

  29. Abou Hussein B, Al Marzouqi O, Khammas A. Anastomotic gastro-jejunal ulcer perforation following one anastomosis gastric bypass: clinical presentation and options of management-case series and review of literature. Obes Surg. 2020;30(6):2423–8. https://doi.org/10.1007/s11695-020-04423-5.

    Article  PubMed  Google Scholar 

  30. Kermansaravi M, DavarpanahJazi AH, ShahabiShahmiri S, Carbajo M, Vitiello A, Parmar CD, Musella M. Areas of non-consensus around one anastomosis/mini gastric bypass (OAGB/MGB): a narrative review. Obes Surg. 2021;31(6):2453–63. https://doi.org/10.1007/s11695-021-05276-2.

  31. Kermansaravi M, Shahmiri SS, DavarpanahJazi AH, Valizadeh R, Berardi G, Vitiello A, Musella M, Carbajo M. One anastomosis/mini-gastric bypass (OAGB/MGB) as revisional surgery following primary restrictive bariatric procedures: a systematic review and meta-analysis. Obes Surg. 2021;31(1):370–83. https://doi.org/10.1007/s11695-020-05079-x.

  32. Felsenreich DM, Langer FB, Bichler C, Eichelter J, Jedamzik J, Gachabayov M, Mairinger M, Richwien P, Prager G. Surgical technique of diverted one-anastomosis gastric bypass. Surg Technol Int. 2021;39:107–12. https://doi.org/10.52198/21.STI.39.GS1485.

    Article  PubMed  Google Scholar 

  33. Rutledge R, Kular K, Manchanda N. The mini-gastric bypass original technique. Int J Surg. 2019;61:38–41. https://doi.org/10.1016/j.ijsu.2018.10.042.

  34. Mahawar KK, Parmar C, Graham Y. One anastomosis gastric bypass: key technical features, and prevention and management of procedure-specific complications. Minerva Chir. 2019;74(2):126–36. https://doi.org/10.23736/S0026-4733.18.07844-6.

  35. Bruzzi M, Chevallier JM, Czernichow S. One-anastomosis gastric bypass: why biliary reflux remains controversial? Obes Surg. 2017;27(2):545–7. https://doi.org/10.1007/s11695-016-2480-x.

    Article  PubMed  Google Scholar 

  36. Robert M, Espalieu P, Pelascini E, Caiazzo R, Sterkers A, Khamphommala L, Poghosyan T, Chevallier JM, Malherbe V, Chouillard E, Reche F, Torcivia A, Maucort-Boulch D, Bin-Dorel S, Langlois-Jacques C, Delaunay D, Pattou F, Disse E. 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. Lancet. 2019;393(10178):1299–309. https://doi.org/10.1016/S0140-6736(19)30475-1. Epub 2019 Mar 6. Erratum in: Lancet. 2019 Mar 30;393(10178):1298

    Article  PubMed  Google Scholar 

  37. Musella M, Susa A, Manno E, De Luca M, Greco F, Raffaelli M, Cristiano S, Milone M, Bianco P, Vilardi A, Damiano I, Segato G, Pedretti L, Giustacchini P, Fico D, Veroux G, Piazza L. Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg. 2017;27(11):2956–67. https://doi.org/10.1007/s11695-017-2726-2.

    Article  PubMed  Google Scholar 

  38. Obeid NR, Malick W, Concors SJ, Fielding GA, Kurian MS, Ren-Fielding CJ. Long-term outcomes after Roux-en-Y gastric bypass: 10- to 13-year data. Surg Obes Relat Dis. 2016;12(1):11–20. https://doi.org/10.1016/j.soard.2015.04.011.

  39. Higa K, Ho T, Tercero F, Yunus T, Boone KB. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7(4):516–25. https://doi.org/10.1016/j.soard.2010.10.019. Epub 2010 Nov 26

    Article  PubMed  Google Scholar 

  40. Liagre A, Debs T, Kassir R, Ledit A, Juglard G, Chalret du Rieu M, Lazzati A, Martini F, Petrucciani N. One anastomosis gastric bypass with a biliopancreatic limb of 150 cm: weight loss, nutritional outcomes, endoscopic results, and quality of life at 8-year follow-up. Obes Surg. 2020;30(11):4206–17. https://doi.org/10.1007/s11695-020-04775-y. Erratum in: Obes Surg. 2021 Jun;31(6):2848

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Minimally Invasive Surgery, Cedars Sinai Medical Center, 8635 W 3rd st Suite 601, Los Angeles, CA, 90048, USA

    Sarah Pivo

  2. Department of Surgery, NYU Langone Health, New York, NY, 10016, USA

    Megan Jenkins, Christine Ren Fielding, Mirhee Kim & Bradley Schwack

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  1. Sarah Pivo
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  2. Megan Jenkins
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Correspondence to Sarah Pivo.

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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. For this type of study, formal consent is not required.

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Key Points

• Patients converted to OAGB from LAGB or SG for weight regain were compared to RYGB

• Patients had similar OR times, complication rates, and 1-month weight loss

• OAGB may be a safe alternative to RYGB for weight regain after LAGB or LSG

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Pivo, S., Jenkins, M., Fielding, C.R. et al. One Anastomosis Gastric Bypass for Revisional Bariatric Surgery: Assessment of Short-Term Safety. OBES SURG 33, 2108–2114 (2023). https://doi.org/10.1007/s11695-023-06608-0

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