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Conversion of Sleeve Gastrectomy to One Anastomosis Gastric Bypass for Weight Loss Failure

  • Tigran PoghosyanEmail author
  • Ali Alameh
  • Matthieu Bruzzi
  • Adrien Faul
  • Claire Rives-Lange
  • Franck Zinzindohoue
  • Richard Douard
  • Jean-Marc Chevallier
Original Contributions

Abstract

Introduction

One anastomosis gastric bypass (OAGB) was suggested as an option in the management of weight loss failure after sleeve gastrectomy (SG). In parallel, the length of the biliopancreatic limb (BPL) is currently debated.

Objectives

To evaluate morbidity and efficiency of the conversion of SG to OAGB using two lengths of BPL (150 cm versus 200 cm).

Methods

Retrospective analysis of a prospectively collected database on 72 patients operated on between 2007 and 2017: (200-cm BPL before 2014 versus 150-cm BPL since 2014).

Results

At revision, the mean body mass index (BMI) was 43.6 ± 7 kg/m2. Sixteen patients (20%) had type 2 diabetes (T2D) and 23 (29%) had obstructive sleep apnea (OSA). Early morbidity rate was 4.2% (n = 3). Mean BMI were 33.7 ± 6 and 34.8 ± 9 at 2 and 5 years, respectively. At 5 years, the rate of lost of follow-up was 34%. T2D and OSA improved in 80% (n = 12) and 70% (n = 16) of the patients, respectively. At revision, the mean BMI were 46 ± 8 kg/m2 and 41 ± 6 kg/m2 for patients with 200-cm BPL (n = 38) and 150-cm BPL (n = 34), respectively. Two years after conversion, the mean BMI were 34 ± 1 kg/m2 for 200-cm BPL and 32 ± 7 kg/m2 for 150-cm BPL. The rate of gastroesophageal reflux disease (GERD) and diarrhea was 13% and 5% in patients with 200-cm BPL versus 3% and 0% in patients with 150-cm BPL.

Conclusion

This study shows that the conversion of SG to OAGB is feasible and safe allowing significant weight loss and improvement in comorbidities. Weight loss seems comparable between the 150-cm and 200-cm BPL.

Keywords

Sleeve gastrectomy Weight loss failure Revisional surgery One anastomosis gastric bypass 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval Statement

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

Informed Consent Statement

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

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Digestive, Oncologic and Bariatric SurgeryAP-HP, Hôpital Européen Georges Pompidou and Université Paris DescartesParisFrance
  2. 2.Department of nutritionAP-HP, Hôpital Européen Georges Pompidou and Université Paris DescartesParisFrance

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