Does One-Anastomosis Gastric Bypass Expose Patients to Gastroesophageal Reflux: a Systematic Review and Meta-analysis

Esparham, Ali; Ahmadyar, Soheil; Zandbaf, Tooraj; Dalili, Amin; Rezapanah, Alireza; Rutledge, Robert; Khorgami, Zhamak

doi:10.1007/s11695-023-06866-y

Cited by 3 publications

(2 citation statements)

References 111 publications

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“…More data are needed on the incidence of de-novo reflux after RYGB and OAGB, including comparative metaanalyses. A recent meta-analysis on new-onset reflux after OAGB reported a 6% incidence of GERD, with esophagitis and Barrett's esophagus rates of 15% and 1%, respectively (43). In our study the incidence of GERD was higher but we highlight that a longer follow-up may be responsible for this difference.…”

Section: Discussioncontrasting

confidence: 44%

Analysis of Factors Related to Gastroesophageal Reflux After Gastric Bypass at 10-Year Follow-up: A Retrospective Single-institutional Study

PETRUCCIANI,

BENOIS,

AURELLO

et al. 2024

In Vivo

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Background/Aim: Long-term gastroesophageal reflux (GERD) after gastric bypass for obesity is underestimated. The present study aimed to evaluate the rate of treated GERD and the factors influencing it in a cohort of patients who underwent gastric bypass. Patients and Methods: Patients who underwent one-anastomosis gastric bypass (OAGB) or Roux-en-Y gastric bypass (RYGB) as a primary bariatric procedure between 2010 and 2011 at a French private referral center were included in the study. The primary endpoint was the 10-year prevalence of GERD. Results: In total, 422 patients underwent RYGB and 334 underwent OAGB with a biliopancreatic limb of 150 cm. The mean age was 38.9±11.3 years, and 81.6% of patients were female; the mean preoperative body mass index was 42.8±5 kg/m 2 . Preoperative GERD was diagnosed in 40.8% of patients in the total cohort, 31.7% in the RYGB group versus 49.1% in the OAGB group (p<0.0001). At 10-year followup, the rate of GERD was 21.1%, with no difference between the two groups. Remission of preoperative GERD and de novo GERD were comparable between the two types of bypass. Surgery for GERD resistant to medical treatment was more frequent in the OAGB group. At multivariate analysis, factors significantly correlated with long-term GERD were: Preoperative GERD, total weight loss at 120 months <25%, glycemic imbalances and anastomotic ulcers. Conclusion: Identification and correction of modifiable factors may help reduce the incidence of long-term GERD.

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Section: Discussioncontrasting

confidence: 44%

Analysis of Factors Related to Gastroesophageal Reflux After Gastric Bypass at 10-Year Follow-up: A Retrospective Single-institutional Study

PETRUCCIANI,

BENOIS,

AURELLO

et al. 2024

In Vivo

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“…Sucralfate and PPI medications can help; however, resistant cases would warrant a revision to RYGB. The new-onset reflux rate after OAGB was significantly higher than gastric bypass but not different with sleeve gastrectomy (18). Braun anastomosis is not common and needed in only 0.7% of OAGB patients in large OAGB series (19; 20).…”

Section: Management Of Biliary Gastritismentioning

confidence: 96%

One Anastomosis Gastric Bypass is an acceptable version of Gastric Bypass

Hussain

2023

Brit J Of Surg Sci

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The Roux-en-Y gastric bypass (RYGB) has been considered a gold standard procedure in bariatric surgery for many years and yet there is no definite standardisation1. RYGB has a small gastric pouch, different biliopancreatic limb lengths, Roux limb [alimentary limb] and the common channel. Standardization of the procedure is suggested in the 2019 Bhandari et al study2. It suggested <30mls gastric pouch capacity, the total length of BPL and the Roux limb is 200cm with each limb could be 50-150cm. There was no mention of the common channel length. The proximal RYGB with short BPL is expected to be associated with an increasing risk of failure, weight regain and relapse of the comorbidities, while the distal type is associated with severe hypoproteinaemia, malnutrition, liver failure and increasing risk of mortality, but superior efficacy3. The adjustment of the BPL and bypassed intestinal length is the safety and efficacy key factor for both OAGB and RYGB.

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One-Anastomosis Gastric Bypass (OABG) vs. Single Anastomosis Duodeno-Ileal Bypass (SADI) as revisional procedure following Sleeve Gastrectomy: results of a multicenter study

Gallucci,

Marincola,

Pennestrì

et al. 2024

Langenbecks Arch Surg

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Purpose Sleeve Gastrectomy (SG) is the most performed bariatric surgery, but a considerable number of patients may require revisional procedures for suboptimal clinical response/recurrence of weight (SCR/RoW). Conversion options include One-Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Ileal Bypass (SADI). The study aims to compare SADI vs. OAGB as revisional procedures in terms of early and mid-term complications, operative time, postoperative hospital stay and clinical outcomes. Methods All patients who underwent OAGB or SADI as revisional procedures following SG for SCR/RoW at three high-volume bariatric centers between January 2014 and April 2021 were included. Propensity score matching (PSM) analysis was performed. Demographic, operative, and postoperative outcomes of the two groups were compared. Results One hundred and sixty-eight patients were identified. After PSM, the two groups included 42 OAGB and 42 SADI patients. Early (≤ 30 days) postoperative complications rate did not differ significantly between OAGB and SADI groups (3 bleedings vs. 0, p = 0.241). Mid-term (within 2 years) complications rate was significantly higher in the OAGB group (21.4% vs. 2.4%, p = 0.007), mainly anastomotic complications and reflux disease (12% of OAGBs). Seven OAGB patients required conversion to another procedure (Roux-en-Y Gastric Bypass—RYGB) vs. none among the SADI patients (p = 0.006). Conclusions SADI and OAGB are both effective as revisional procedures for SCR/RoW after SG. OAGB is associated with a significantly higher rate of mid-term complications and a not negligible rate of conversion (RYGB). Larger studies are necessary to draw definitive conclusions.

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Does One-Anastomosis Gastric Bypass Expose Patients to Gastroesophageal Reflux: a Systematic Review and Meta-analysis

Cited by 3 publications

References 111 publications

Analysis of Factors Related to Gastroesophageal Reflux After Gastric Bypass at 10-Year Follow-up: A Retrospective Single-institutional Study

Analysis of Factors Related to Gastroesophageal Reflux After Gastric Bypass at 10-Year Follow-up: A Retrospective Single-institutional Study

One Anastomosis Gastric Bypass is an acceptable version of Gastric Bypass

One-Anastomosis Gastric Bypass (OABG) vs. Single Anastomosis Duodeno-Ileal Bypass (SADI) as revisional procedure following Sleeve Gastrectomy: results of a multicenter study

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