Introduced by Rutledge in 1997, MGB has now become a commonly performed bariatric operation in Europe and in the Asia/Pacific region. Early complications are defined as complications occurring within the first 30 postoperative days. In our experience of 2678 patients, 3.1% suffered from early complications. Among them, 74/2251 patients (3.2%) developed an early complication following a primary MGB, while 10/427 patients (2.3%) presented a complication following revision to an MGB.
Four categories of major early complications can be distinguished: bleeding, leaks, small bowel perforation, and anastomotic stenosis. Bleeding is the most common complication, with a total rate of 1.71%, and can be divided into intra-abdominal and endoluminal bleeding. Leaks are the second most common complication, and they include anastomotic leaks and gastric pouch leaks. The complication rate in our series is 0.18% for leaks on the anastomotic suture-line and 0.26% for leaks of the gastric pouch. Small bowel perforation is the third complication in terms of rate (0.22%). Similar to RYGB, perforation in MGB seems to be strongly associated with marginal ulcer. Anastomotic stenosis has a rate of 0.18% and is probably due to anastomotic tension, ischemia and subclinical leaks.
Other complications reported are abdominal wall hernias (rate 0.14%), gastroparesis (0.03%), abdominal abscess (0.07%), and wound infection (0.03%).
Comparing the results with other large series, MGB technique has demonstrated a lower rate of early complications compared to both LSG and RYGB. Moreover, the safety and efficacy of MGB make it a valid option for technically difficult super-obese patients.
MGB Early complications Bleeding Leaks Small bowel perforation Anastomotic stenosis
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Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242:20–8.CrossRefPubMedPubMedCentralGoogle Scholar
Christou N, Efthimiou E. Five-year outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in a comprehensive bariatric surgery program in Canada. Can J Surg. 2009;52:E249–58.PubMedPubMedCentralGoogle Scholar
Taha O, Abdelaal M, Abozeid M, Askalany A, Alaa M. Outcomes of omega loop gastric bypass, 6-years experience of 1520 Cases. Obes Surg. 2017;27:1952–60.CrossRefPubMedGoogle Scholar
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 (5years) follow-up. Obes Surg. 2017;27:2956–67. https://doi.org/10.1007/s11695-017-2726-2.CrossRefPubMedGoogle Scholar
Dindo D, Demartines S, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentralGoogle Scholar
Carbajo MA, Luque-de-León E, Jiménez JM, Ortiz-de-Solórzano J, Pérez-Miranda M, Castro-Alija MJ. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27:1153–67.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25:951–8.CrossRefPubMedGoogle Scholar
Tolone S, Cristiano S, Savarino E, Lucido FS, Fico DI, Docimo L. Effects of omega-loop bypass on esophagogastric junction function. Surg Obes Relat Dis. 2016;12:62–9.CrossRefPubMedGoogle Scholar
Woodward GA, Morton JM. Stomal stenosis after gastric bypass. In: Deitel M, Gagner M, Dixon JB, Himpens J, editors. Handbook of obesity surgery. Toronto: FD-Communications; 2010. p. 102–7.Google Scholar
Johnson WH, Fernanadez AZ, Farrell TM, et al. Surgical revision of loop (“mini”) gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007;3:37–41.CrossRefPubMedGoogle Scholar
Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24:1749–56.CrossRefPubMedGoogle Scholar
Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11:321–6.CrossRefPubMedGoogle Scholar
Musella M, Susa A, Greco F, De Luca M, Manno E, Di Stefano C, Milone M, Bonfanti R, Segato G, Antonino A, Piazza L. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28:156–63.CrossRefPubMedGoogle Scholar
Jammu GS, Sharma R. 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. 2016;26:926–32.CrossRefPubMedGoogle Scholar
Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254:410–22.CrossRefPubMedPubMedCentralGoogle Scholar
Rausa E, Bonavina L, Asti E, et al. Rate of death and complications in laparoscopic and open Roux-en-Y gastric bypass. A meta analysis and meta-regression analysis on 69,494 patients. Obes Surg. 2016;26:1956–63.CrossRefPubMedGoogle Scholar
Gagner M, Deitel M, Erickson AL, Crosby R. Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. Obes Surg. 2013;23:2013–7.CrossRefPubMedGoogle Scholar