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

Abstract

Introduction: Bariatric surgeries are effective in treating obesity and its associated co-morbidities. The ideal bariatric surgery with satisfactory weight or BMI loss and with few complications and nutritional deficiencies still does not exist. Modifications in one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) are still under study for best BMI loss with few complications. Objective: The aim of the current work was to compare both surgeries, OAGB and RYGB, after limb length modification regarding postoperative complications, resolution of comorbidities, BMI and weight loss, and operative time. Patients and Methods: In this prospective cohort study, we reviewed medical records of 200 patients undergoing mini gastric bypass (MGB) and RYGB with limb length modification. Patients were then followed postoperatively for BMI loss, estimated weight loss, resolution of comorbidities, and postoperative complications. Patients were phone called and asked to attend next day for follow-up. Results: A total of 200 patients were included. Thirteen patients were lost during follow-up. OAGB group has a statistically significant lower BMI and weight at 3, 6, 12, 24 months compared to RYGB group. Regarding operative time, minutes, OAGB group has a significantly lower operative time compared to RYGB group (p=0.0001). Patients who had OAGB had a significantly higher EWL compared to RYGB at 3, 6, 12, 24 months. Regarding resolution of comorbidities and postoperative complications, no significant difference between both groups, MGB vs RYGB (p=0.89) and (p=0.98), respectively. Conclusion: It could be concluded that OAGB is superior to RYGB in BMI and excess weight loss at 3, 6, 12, 24 months, OAGB had lower operative time. No difference between both surgeries in postoperative complications and resolution of comorbidities.

Long Biliopancreatic Limb Roux-En-Y Gastric Bypass Versus One-Anastomosis Gastric Bypass: a Randomized Controlled Study

“…As far as we know, only three studies compared OAGB and long BPL RYGB. Two were retrospective [ 24 , 25 ], and only one was an RCT [ 26 ] to determine if morbid obesity patients can benefit from lengthening the BPL in RYGB. In the RCT, the authors changed the ratio of AL to BPL so that the BPL was longer (150 cm) than the AL (60 cm).…”

“…Fouly et al [ 25 ] stated that OAGB was superior to long BPL RYGB regarding BMI and excess weight loss at 3, 6, 12, and 24 months, with no differences regarding comorbidity resolution.…”