Advertisement

Obesity Surgery

, Volume 29, Issue 2, pp 542–551 | Cite as

Tailored One Anastomosis Gastric Bypass: 3-Year Outcomes of 94 Patients

  • Theodoropoulos Charalampos
  • Natoudi Maria
  • Vrakopoulou Gavriella Zoi VrakopoulouEmail author
  • Triantafyllou Tania
  • Dimitrios Raptis
  • Zografos George
  • Leandros Emmanouil
  • Albanopoulos Konstantinos
Original Contributions

Abstract

Background

One anastomosis gastric bypass (OAGB) claims its place among bariatric operations, proving itself a safe and effective procedure.

Methods

This is a retrospective analysis of prospectively collected data regarding 94 patients who underwent surgery in a single surgical unit. Tailoring of the biliopancreatic limb length decided upon preoperative BMI was applied. Patients’ excess weight loss and resolution of comorbidities were evaluated. Data on patients’ nutritional status is also presented.

Results

Mean BMI reduction at 36 months postoperatively was 21.7 ± 6.3 kg/m2. Mean excess weight loss (%EWL) was 83.6%, 91.8%, and 92.5% at 12, 24, and 36 months postoperatively, respectively. When controlling for preoperative BMI, a 36-month %EWL of 89.1% for the 2-m subgroup, a 95.3% for the 2.5-m subgroup, and a 104.7% for the 3-m subgroup were found. Operation’s success, defined as %EWL greater than 50%, was 97.9% 36 months postoperatively. All patients suffering from hypertension, diabetes, and dyslipidemia achieved full remission. Furthermore, the percentage of patients with obstructive sleep apnea and gastroesophageal reflux disease, achieving full remission was 91.7% and 86.7%, respectively. An incidence of 5.3% new onset regurgitation was noted. Iron deficiency presented in 26 (27.7%) patients postoperatively, vitamin B12 deficiency in 13 (13.8%), folic acid deficiency in 18 (19.1%), and mild hypoalbuminemia in 7 (7.4%). Major early postoperative complications (Clavien-Dindo grade ≥ 3) were reported in 1.7% of our patients. One (1.1%) patient developed marginal ulcer and two (2.2) patients had late dumping.

Conclusions

OAGB is a safe and efficient technique; however, careful selection of patients and postoperative surveillance with respect to weight regain and nutritional deficiencies are mandatory for optimal results.

Keywords

Bariatric surgery Metabolic surgery One anastomosis gastric bypass (OAGB) OAGB effectiveness OAGB results Comorbidities after OAGB EWL after OAGB Tailoring OAGB 

Notes

Compliance with ethical standards

Conflict of Interest

All authors declare no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

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.

References

  1. 1.
    Mason E, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47(6):1345–51.CrossRefGoogle Scholar
  2. 2.
    Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11:276–80.CrossRefGoogle Scholar
  3. 3.
    Rutledge R, Walsh W. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15:1304–8.CrossRefGoogle Scholar
  4. 4.
    Mahawar K, Car WR, Balupuri S, et al. Controversy surrounding “mini” gastric bypass. Obes Surg. 2014;24(2):324–33.CrossRefGoogle Scholar
  5. 5.
    Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow up in 1200 patients. Obes Surg 2017;27:1153.  https://doi.org/10.1007/s11695-016-2428-1.
  6. 6.
    Carbajo M, Luque-de-León E. Mini-gastric bypass/one-anastomosis gastric bypass-standardizing the name. Obes Surg. 2015;25:858–9.CrossRefGoogle Scholar
  7. 7.
    Magouliotis D, Tasiopoulou V, 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.CrossRefGoogle Scholar
  8. 8.
    Rutledge R. Naming the mini-gastric bypass. Obes Surg. 2014;24(8):2173.CrossRefGoogle Scholar
  9. 9.
    Carbajo M, Garcia-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.CrossRefGoogle Scholar
  10. 10.
    Albanopoulos K, Alevizos L, Natoudi M, et al. C-reactive protein, white blood cells, and neutrophils as early predictors of postoperative complications in patients undergoing laparoscopic sleeve gastrectomy. Surg Endosc. 2013;27(3):864–71.CrossRefGoogle Scholar
  11. 11.
    Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22:697–703.CrossRefGoogle Scholar
  12. 12.
    Wang W, Wei PL, Lee YC, et al. Short-term results of laparoscopic mini-gastric bypass. Obes Surg. 2005;15(5):648–54.CrossRefGoogle Scholar
  13. 13.
    Lessing Y, Pencovich N, Khatib M, et al. One-anastomosis gastric bypass: first 407 patients in 1 year. Obes Surg. 2017;27:2583–9.CrossRefGoogle Scholar
  14. 14.
    Mahawar K, Jennings N, Brown K, et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23(11):1890–8.CrossRefGoogle Scholar
  15. 15.
    Musella M, Susa A, Greco F, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;25:156–63.CrossRefGoogle Scholar
  16. 16.
    Georgiadou D, Sergentanis T, Nixon A, et al. Efficacy and safety of laparoscopic mini gastric bypass. A systematic review. Surg Obes Relat Dis. 2014;10:984–91.CrossRefGoogle Scholar
  17. 17.
    Papadia F. Effect of standard versus extended roux limb length on weight loss outcomes after laparoscopic roux-en-Y gastric bypass. Surg Endosc. 2004;18(11):1683.Google Scholar
  18. 18.
    Mahawar K, Kumar P, Parmar C, et al. Small bowel limb lengths and roux-en-Y gastric bypass: a systematic review. Obes Surg. 2016;26:660–71.CrossRefGoogle Scholar
  19. 19.
    Choban PS, Flancbaum L. The effect of roux limb lengths on outcome after roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg. 2002;12(4):540–5.CrossRefGoogle Scholar
  20. 20.
    Nergaard BJ, Leifsson BG, Hedenbro J, et al. Gastric bypass with long alimentary or long pancreato-biliary limb—long term results on weight loss, resolution of comorbidities and metabolic parameters. Obes Surg. 2014;24(10):1595–602.CrossRefGoogle Scholar
  21. 21.
    Chakhtoura G, Zinzindohoué GY, Ruseykin I, et al. Primary results of laparoscopic mini-gastric bypass in a French obesity-surgery specialized university hospital. Obes Surg. 2008;18:1130–3.CrossRefGoogle Scholar
  22. 22.
    Taha OS, Abdelaal M, Abozeid M, et al. Outcomes of one anastomosis gastric bypass in 472 diabetic patients. Obes Surg. 2017;27:2802–10.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Theodoropoulos Charalampos
    • 1
  • Natoudi Maria
    • 1
  • Vrakopoulou Gavriella Zoi Vrakopoulou
    • 1
    Email author
  • Triantafyllou Tania
    • 1
  • Dimitrios Raptis
    • 2
  • Zografos George
    • 1
  • Leandros Emmanouil
    • 1
  • Albanopoulos Konstantinos
    • 1
  1. 1.First Propaedeutic Surgical Clinic, Hippocratio Athens General Hospital, Athens Medical SchoolNational and Kapodistrian University of AthensAthensGreece
  2. 2.Department of General SurgeryHellenic Air Force 251 General HospitalAthensGreece

Personalised recommendations