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Essentials of Mini ‒ One Anastomosis Gastric Bypass pp 245–272Cite as

Results of the One-Anastomosis Gastric Bypass (OAGB): Safety, Nutritional Considerations and Effects on Weight, Co-Morbidities, Diabetes and Quality of Life

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Abstract

Morbid obesity is a chronic, progressive, relentless and multifactorial disease leading to catastrophic repercussions for the patient. Although surgery is currently the only effective alternative in its treatment, the “ideal” bariatric operation is yet to be found. After performing many of the available open and laparoscopic options in bariatric surgery, and aware of several issues with the Roux-en-Y gastric bypass which we were performing at the time, we decided to evaluate the Mini-gastric bypass (MGB) which had recently been reported. The laparoscopic One-Anastomosis Gastric Bypass (OAGB) was thus created in the year 2002, as a modification of the MGB with differentiated conceptual principles and technical features. Since then, we have periodically reported our outcomes both in scientific meetings and publications. This chapter updates our experience with a prospectively collected database of now 3000 patients during a 15 year period.

Demographics included age: 43 y.(12–74), BMI: 46 (31–86) and EBW: 65 kg (28–220). There were 4 (0.13%) conversions. Length of stay for uncomplicated patients (99%) was 24 h. (15–120) and 9 days (4–32) for those with major complications. These prompted further operations in 23 (0.9%) and were solved conservatively in 12 (0.4%). Long-term complications occurred in 83 (2.8%). There were three deaths (0.1%) due to PTE, nosocomial pneumonia and DIC. Postoperative %EWL was 84%, 81%, 77%, 70% and 70% at 1,3,5,10 and 15 years, respectively. Overall total or partial resolution of co-morbidities was achieved in 97% and 92% at 2 and 15 years, respectively. Quality of life (GIQoLI) was satisfactory in all parameters assessed postoperatively.

OAGB provides reduced difficulty and very low morbidity-mortality. Long term %EWL and co-morbidity resolution are similar to the best results obtained with more aggressive and complex operations. OAGB has established itself as one of the safest and more effective alternatives in bariatric surgery.

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Abbreviations

BMI:

Body mass index

BP:

Biliopancreatic

BR:

Bile reflux

BS:

Bariatric surgery

EAC:

European accreditation council

EG:

Esophago-gastric

EW:

Excess weight

EWL:

Excess weight loss

FU:

Follow-up

GERD:

Gastroesophageal reflux disease

GI:

Gastrointestinal

HP:

Helicobacter pylori

IFSO:

International Federation for the Surgery of Obesity and Metabolic Disorders

IWQoL:

Impact of weight on quality of life

LAGB:

Laparoscopic adjustable gastric banding

LOS:

Lenght of stay

LSG:

Laparoscopic sleeve gastrectomy

LSML:

Left subcostal mini-laparotomy

MGB:

Mini-gastric bypass

MO:

Morbid obesity

MU:

Marginal ulcers

NPO:

Nil per os

OAGB:

One anastomosis gastric bypass

PPI’s:

Proton pump inhibitors

QoL:

Quality of life

RYGB:

Roux-Y gastric bypass

SB:

Small bowel

SBO:

Small bowel obstruction

TPN:

Total parenteral nutrition

WL:

Weight loss

WR:

Weight regain

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Authors and Affiliations

  1. Center of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain

    Enrique Luque-de-León MD & Miguel A. Carbajo MD, PhD

  2. Center of Excellence for the Study and Treatment of Obesity and Diabetes—Latinamerican Affiliated Subsidiary/The American British Cowdray Medical Center, I.A.P. /Hospital de Especialidades—Centro Médico Nacional (IMSS), México City, Mexico

    Enrique Luque-de-León MD

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  1. Enrique Luque-de-León MD
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  1. Obesity Surgery, Toronto, Ontario, Canada

    Mervyn Deitel

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Luque-de-León, E., Carbajo, M.A. (2018). Results of the One-Anastomosis Gastric Bypass (OAGB): Safety, Nutritional Considerations and Effects on Weight, Co-Morbidities, Diabetes and Quality of Life. In: Deitel, M. (eds) Essentials of Mini ‒ One Anastomosis Gastric Bypass. Springer, Cham. https://doi.org/10.1007/978-3-319-76177-0_25

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