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

Musella, Mario; Susa, A; Manno, Emilio; Luca, Maurizio De; Greco, Francesco; Raffaelli, Marco; Cristiano, Stefano; Milone, Marco; Bianco, Paolo; Vilardi, Antonio; Damiano, Ivana; Segato, G; Pedretti, Laura; Giustacchini, Piero; Fico, Domenico; Veroux, G; Piazza, Luigi

doi:10.1007/s11695-017-2726-2

Cited by 168 publications

(107 citation statements)

References 58 publications

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“…Similar results have been reported by others after these operations . The hypoalbuminemia is an issue of concern after OAGB as, in some reports, a subset of patients with protein caloric malnutrition became intractable, resulting in liver failure and the need for surgical re‐intervention and resulted in mortality in some cases . No patient in this series developed liver failure; however, two patients in the OAGB group had reoperations: one was a reversal because of excessive weight loss and hypoalbuminemia associated with an intractable marginal ulcer, and the other was a revision operation because of hypoalbuminemia.…”

Section: Discussionsupporting

confidence: 85%

OAGB vs BGBP: A retrospective comparative study of a cohort of patients who had bariatric surgery in 2012 at one centre by a single surgeon

et al. 2019

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Summary Two modifications of Roux‐en‐Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB) and Roux‐en‐Y banded gastric bypass (BGBP), are gaining popularity in use because the OAGB is reported to be a simpler operation, and the BGBP is reported to have sustained weight loss compared to standard RYGB. A retrospective review and analysis of data comparing outcomes up to 5 years after BGBP and OAGB from a prospectively maintained database of all bariatric metabolic operations in 2012 was performed. Eighty‐two patients underwent a BGBP and 90 an OAGB. The average age and body mass index were 44.12 and 43.97 and 43.57 and 45.79 in the BGBP and OAGB groups, respectively. Postoperative nutrient deficiencies were similar in both groups but were more prominent in the OAGB group. The % excess body weight loss (%EBWL) was 78% and 71.5% at 5 years in the OAGB and BGBP groups, respectively. The % total weight loss (%TWL) was also higher in OAGB compared to the BGBP group, 34.72% and 30.49%, respectively. Resolution of type 2 diabetes (T2DM) was significantly higher in the OAGB group, 79.16%, than in the BGBP group, 71.42%. The resolution of dyslipidaemia and hypertension were similar in both groups, but sleep apnoea resolution was higher in OAGB group. Both operations produced excellent weight loss in the intermediate term. The %EBWL and resolution of T2DM were significantly higher after the OAGB operation at the expense of increased incidence of nutrient deficiencies and hypoproteinemia. Quality of life improvement and patient satisfaction were high after both operations. Long‐term follow up and multicentre prospective studies are needed to confirm these intermediate outcomes.

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Section: Discussionsupporting

confidence: 85%

OAGB vs BGBP: A retrospective comparative study of a cohort of patients who had bariatric surgery in 2012 at one centre by a single surgeon

et al. 2019

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“…In regard to the safety profile of laparoscopic OAGB, according to the currently available evidence, there are acceptable early and late complication rates, and the frequency of symptomatic bile reflux is lower than firstly feared, although this information mainly relies on self-reporting (7,(24)(25)(26) .…”

Section: Discussionmentioning

confidence: 99%

Early Weight Loss Outcomes and Glucose Metabolism Parameters After Banded Versus Non-Banded One Anastomosis Gastric Bypass: A Prospective Randomized Trial

Cazzo

Valerini

Chaim

et al. 2019

Arq. Gastroenterol.

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BACKGROUND: The influence of the placement of a band on the outcomes of one anastomosis gastric bypass (OAGB) has not been appropriately studied yet. OBJECTIVE: To compare early weight loss and glucose metabolism parameters following banded versus non-banded OAGB. METHODS: A prospective randomized study, which evaluated 20 morbidly obese individuals who underwent banded and non-banded OAGB and were followed-up for three months. Weight loss (percentage of excess weight loss - %EWL and percentage of body mass index loss - %BMIL) and glucose metabolism outcomes (glucose, insulin and homeostasis model assessment - HOMA) were compared. RESULTS: The banded group presented a significantly higher %EWL at one month (29.6±5.5% vs 17.2±3.4%; P<0.0001) and two months post-surgery (46±7% vs 34.2±9%; P=0.004544), as well as a significantly higher %BMIL at one month (9.7±1.1% vs 5.8±0.8%; P<0.0001), two months (15±1.4% vs 11.5±2.1; P=0.000248), and three months (18.8±1.8% vs 15.7±3.2%; P=0.016637). At three months, banded OAGB led to significant decreases of insulin (14.4±4.3 vs 7.6±1.9; P=0.00044) and HOMA (3.1±1.1 vs 1.5±0.4; P=0.00044), whereas non-banded OAGB also led to significant decreases of insulin (14.8±7.6 vs 7.8±3.1; P=0.006) and HOMA (3.2±1.9 vs 1.6±0.8; P=0.0041). The percent variation of HOMA did not significantly differ between banded and non-banded OAGB (P=0.62414); overall, the percent variation of HOMA was not correlated with %EWL (P=0.96988) or %BMIL (P=0.82299). CONCLUSION: Banded OAGB led to a higher early weight loss than the standard technique. Banded and non-banded OAGB led to improvements in insulin resistance regardless of weight loss.

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“…Although longer limb can induce greater weight loss, major complications such as EWL and malnutrition are more common in longer limb lengths,[ 8 ] especially longer than 250 cm. [ 30 ] GJ anastomosis usually is created with a 45-mm stapler, and competency of the anastomosis can be assured by a leak test. [ 4 5 8 15 18 ]…”

Section: Resultsmentioning

confidence: 99%

“…Usually, waiting at least 15 s before firing allows adequate compression time before cutting the tissue by staplers. [ 30 ] After a few seconds of delay following jaws lock, the stapler gun should fire slowly. [ 3 31 32 33 ]…”

Section: How To Prevent Intraoperative Complicationsmentioning

confidence: 99%

One-anastomosis gastric bypass as an alternative procedure of choice in morbidly obese patients

et al. 2018

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One-anastomosis gastric bypass is an attractive bariatric procedure. It is effective in weight loss and comorbidity resolution. It is a relatively simple and fast operation with low complication rates that make it a suitable option in super-obese individuals. Although not proven yet, there are some concerns about its long-term safety profile in terms of biliary reflux, marginal ulcer, and esophagogastric malignancy. In this article, we review the technique of this procedure and discuss about some practical surgical highlights. Furthermore, we overview studies performed about this procedure and compare it to some other well-established bariatric operations, while providing a detailed study about the facts related to its outcomes and complications.

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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

Cited by 168 publications

References 58 publications

OAGB vs BGBP: A retrospective comparative study of a cohort of patients who had bariatric surgery in 2012 at one centre by a single surgeon

OAGB vs BGBP: A retrospective comparative study of a cohort of patients who had bariatric surgery in 2012 at one centre by a single surgeon

Early Weight Loss Outcomes and Glucose Metabolism Parameters After Banded Versus Non-Banded One Anastomosis Gastric Bypass: A Prospective Randomized Trial

One-anastomosis gastric bypass as an alternative procedure of choice in morbidly obese patients

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