Conversion of laparoscopic sleeve gastrectomy after weight loss failure into laparoscopic one anastomosis gastric bypass: short-term safety and efficacy and effect of indications on outcome

Gerges, W B; Omran, Hisham; Makram, Fady

doi:10.1007/s00464-021-08374-5

Cited by 6 publications

(2 citation statements)

References 54 publications

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“…As for re‐OAGB, we found an EWL of 86.7% 2 years after revisional surgery. This percentage was comparable to the EWL of 88.2% and 84.1% at 2‐years follow‐up in two studies by Petrucciani et al 44 and Debs et al, 45 and to the EWL of 79% in a study by Gerges et al 46 evaluating re‐OAGB after failure of restrictive procedure. The remarkable difference we found in weight loss outcome (EWL: 86.7% vs 54%) between re‐OAGB and re‐LSG 2 years after revisional surgery underlines the inferior efficacy of re‐adopting a revisional restrictive surgery after an initial failure of primary restrictive surgery, which comes in accordance with two other studies 29,47 that showed a superiority of gastric bypass conversion compared with re‐LSG after failure of restrictive surgery.…”

Section: Discussionsupporting

confidence: 75%

One anastomosis gastric bypass vs sleeve gastrectomy as a revisional bariatric surgery for weight loss failure after primary restrictive procedure

Mouawad,

Dahboul,

Chamaa

et al. 2023

Asian J Endoscop Surgery

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IntroductionWeight loss failure after restrictive bariatric procedures initiated the debate about the choice of an adequate revisional intervention, a question still unanswered. While many surgeons went for a conversion to gastric bypass, others opted for re‐trying a revisional restrictive procedure to avoid the side effects of gastric bypass. The objective of our study was to compare weight loss outcome between revisional laparoscopic sleeve gastrectomy (re‐LSG) and revisional one anastomosis gastric bypass (re‐OAGB) for insufficient weight loss or weight regain following primary restrictive bariatric surgery.Materials and MethodsWe included 20 obese patients, with a history of weight regain or insufficient weight loss after primary restrictive surgery, who underwent re‐LSG (eight patients) or re‐OAGB (12 patients) between January 2018 and January 2021. Patients were followed up 2 years after their revisional intervention. Statistics were performed using IBM® SPSS® software for Windows version 21.ResultsIn the re‐LSG group, the average body mass index (BMI) before primary restrictive procedure was 43.7 kg/m2. The average period between the primary and revisional surgery was 12.6 years. Patients had a nadir BMI of 33.2 kg/m2 during that period and reached a mean BMI of 40.6 kg/m2 before re‐LSG. Two years after re‐LSG, the average BMI was 31.5 kg/m2 with a percent of excess weight loss (%EWL) of 54% and percent of excess BMI loss (%EBMIL) of 66.6%. In the re‐OAGB group, the average BMI before primary restrictive procedure was 39 kg/m2. The average period between the primary and revisional surgery was 10.7 years. Patients had a nadir BMI of 30.5 kg/m2 during that period and reached a mean BMI of 36.5 kg/m2 before re‐OAGB. Two years after re‐OAGB, the average BMI was 27 kg/m2 with a %EWL of 86.7% and %EBMIL of 92.6%.ConclusionFor patients with insufficient weight loss or weight regain following primary restrictive bariatric surgery, re‐OAGB has a better effectiveness in weight reduction compared with re‐LSG after a 2‐year follow up.

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Section: Discussionsupporting

confidence: 75%

One anastomosis gastric bypass vs sleeve gastrectomy as a revisional bariatric surgery for weight loss failure after primary restrictive procedure

Mouawad,

Dahboul,

Chamaa

et al. 2023

Asian J Endoscop Surgery

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“…Our study showed mean BMI, EWL% and %TWL of 34.5 ± 8.5 kg/m 2 , %51.6 ± 11.0 and %26.6 ± 5.9 at 1-year follow-up after conversional OAGB respectively. Gerges et al in a similar study on 28 patients after conversional OAGB resulted in 79% and 31.7% 1-year EWL% and TWL% respectively 10 . Bhandari et al showed 1-year mean BMI, mean EWL% and mean TWL% of 34.3 kg/m 2 , 54.9% and 22% respectively 5 .…”

Section: Discussionmentioning

confidence: 90%

Five-year outcomes of one anastomosis gastric bypass as conversional surgery following sleeve gastrectomy for weight loss failure

Kermansaravi

Karami

Valizadeh

et al. 2022

Sci Rep

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The most accepted procedures as conversion for poor weight changes after sleeve gastrectomy (SG), are malabsorptive surgeries. This study was designed to evaluate the 5-year outcomes of One Anastomosis Gastric Bypass (OAGB) following SG due to weight loss failure and weight regain. From September 2014 to January 2017, totally 23 patients with a history of SG conversion to OAGB in terms of weight loss failure or weight regain who had completed their 5-year follow-ups were studied. Some obesity related co-morbidities containing type-2 diabetes (DM), hypertension (HTN), dyslipidemia, obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) were also investigated at 1, 2, 3 and 5 years after conversional surgery. All cases had remission/improvement in DM, DLP, HTN and OSA 1 year after conversional OAGB. Analysis showed statistically significant (P < 0.001) change in trend of BMI. Mean BMI before conversional surgery, at 1, 2, 3and 5 years were 46.3 ± 10.4, 34.5 ± 8.5, 34.1 ± 8.6, 35.7 ± 8.7 and 37.5 ± 11.6, respectively. Mean percent excess weight loss (%EWL) at 1, 2, 3 and 5 years was 51.6 ± 11.0, 52.9 ± 13.1, 45.5 ± 16.4 and 41.0 ± 18.0, respectively. Mean percent total weight loss (%TWL) at 1, 2, 3 and 5 years was 26.6 ± 5.9, 27.4 ± 7.2, 23.9 ± 9.2 and 20.9 ± 9.3, respectively. OAGB is an effective conversional procedure for insufficient weight loss and weight regain following failed SG and lead to satisfactory changes in obesity associated medical problems. The optimal weight loss results are obtained at 2-year follow-ups and these effects are then reduced.

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Treatment Options for Weight Regain or Insufficient Weight Loss After Sleeve Gastrectomy: a Systematic Review and Meta-analysis

et al. 2022

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Conversion of laparoscopic sleeve gastrectomy after weight loss failure into laparoscopic one anastomosis gastric bypass: short-term safety and efficacy and effect of indications on outcome

Cited by 6 publications

References 54 publications

One anastomosis gastric bypass vs sleeve gastrectomy as a revisional bariatric surgery for weight loss failure after primary restrictive procedure

One anastomosis gastric bypass vs sleeve gastrectomy as a revisional bariatric surgery for weight loss failure after primary restrictive procedure

Five-year outcomes of one anastomosis gastric bypass as conversional surgery following sleeve gastrectomy for weight loss failure

Treatment Options for Weight Regain or Insufficient Weight Loss After Sleeve Gastrectomy: a Systematic Review and Meta-analysis

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