Nutritional Complications After Laparoscopic Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass: A Comparative Systematic Review and Meta-Analysis

Abstract

A systematic review and meta-analysis were carried out involving studies that compared the nutritional complications of Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB); these included the incidence of malnutrition as well as deficiencies of other nutritional elements, such as total protein, albumin, calcium and iron. A comprehensive search strategy was implemented in PubMed, Embase, and the Cochrane Library. Effect sizes included the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs), as well as mean differences (MDs) and 95% CIs of the percentage total weight loss (%TWL) and excess weight loss percentage (%EWL).Thirteen studies were included (12,964 patients, 66.27% females, 53.82% underwent OAGB). At the longest follow-up period (≥3 years), OAGB was associated with significantly higher %TWL (MD=5.41%, 95%CI, 1.52 to 9.29) and %EWL (MD=13.81%, 95%CI, 9.60 to 18.02) compared to RYGB. However, OAGB procedures were associated with malnutrition (OR=3.00, 95%CI, 1.68 to 5.36, p<0.0001), hypoalbuminemia (OR=2.38, 95%CI, 1.65 to 3.43, p<0.0001), hypoproteinemia (OR=1.85, 95%CI, 1.09 to 3.14, p=0.022), anemia (OR=1.38, 95%CI, 1.08 to 1.77, p=0.011), and hypocalcemia (OR=1.78, 95%CI, 1.01 to 3.12, p=0.046). On subgroup analyses, the proportions of anemia and hypoalbuminemia remained significantly higher at longer follow-up periods and in studies published in Asia.Despite the favorable weight loss profile, the unfavorable nutritional consequences of OAGB merits further investigations to explore the malabsorptive element, ethnic variation, and the role of biliopancreatic limb length.

Nutritional Status after Roux-En-Y (Rygb) and One Anastomosis Gastric Bypass (Oagb) at 6-Month Follow-Up: A Comparative Study

“…Furthermore, although 90 days mortality is similar to RYGB, the overall complications rate seems to be significantly reduced [ 10 , 11 ]. Nonetheless, enthusiasm for OAGB is restrained by some disquieting reports indicating a high incidence of postoperative malnutrition and its consequences (in some cases particularly severe) [ 12 , 13 , 14 ]. Yet, the literature on nutritional complications after RYGB and OAGB is still controversial.…”

One Anastomosis Gastric Bypass Versus Roux-En-Y Gastric Bypass: A New Limb Length Modification, is it Effective? A Prospective Cohort Study

“…In a recent metanalysis of 13 studies by Tourky et al (15) , authors concluded that MGB had significantly higher total weight loss and excess weight loss (heterogeneity I 2 =93 and 94% respectively) compared to RYGB, but MGB had higher nutritional deficiencies. These findings could be attributed to length of biliopancreatic limb in included studies.…”

Effectiveness of laparoscopic sleeve gastrectomy and one anastomosis gastric bypass on the resolution of metabolic syndrome — a review

“…A recent meta-analysis conducted by Tourky et al showed that %EWL and %TWL range from 28.88 to 33.8 and 68.21 to 78.1 respectively after one year and from 32.53 to 36.18 and 72.9 to 78.08 respectively after three and more years [57]. Remission rates of T2DM as shown in the randomized study -YOMEGA reach 60% [58].…”