Outcomes of 75 Consecutive Cases of Laparoscopic One-Anastomosis Gastric Bypass

Abstract

Background: Obesity is increasing at an alarming rate in India along with rest of the world. In the National Family and Health survey - IV conducted in 2015-16; 31.3% women and 26.6% men in urban area were obese or over weight. Bariatric surgery has long been introduced for weight control and is well established measure and superior to other weight control measures. Procedures like laparoscopic Roux en Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are more commonly performed than Laparoscopic One Anastomosis Gastric Bypass (LOAGB). Although sufficient data has accumulated in literature regarding the safety and efficacy of LOAGB, some of standard textbooks still mention it as an experimental procedure and not the mainstream procedure. Aims and Objective: The present study was conducted with objective to find out changes in pre-operative and post-operative status of diabetes mellitus, hypertension, dyslipidemia, obstructive sleep apnoea, osteoarthritis, GERD and quality of life after laparoscopic one anastomosis gastric bypass along with its safety and efficacy in Indian population. Material and Methods: The study was conducted at a tertiary care bariatric surgical centre and included 75 consecutive individual operated between January 2016 to December 2017 who underwent Laparoscopic One Anastomosis Gastric Bypass and followed prospectively for minimum 1 year (mean 18 months) and statistical analysis was done using SPSS 21 software. Result: One Anastomosis Gastric Bypass was completed laparoscopically in all the patients without need for conversion to an open procedure. The overall complication with Laparoscopic One Anastomosis Gastric Bypass was 1.3% without any mortality. Mean percentage of excess weight loss (% EWL) achieved was 72.73. 93.9 % patients with diabetes, 67.43% patients with hypertension, 87.1% patient with hyperlipidemia, all the patient with obstructive sleep apnoea and osteoarthritis of knee showed improvement in their disease status. None of the patient showed worsening of gastroesophageal reflux or development of new symptoms of gastro esophageal reflux. All patients had improvement in their quality of life as seen in the improvement of their SF 36 scores. Conclusion: Laparoscopic One Anastomosis Gastric Bypass is a safe and effective bariatric procedure. The post procedure improvement in diabetes, hypertension, hyperlipidemia, obstructive sleep apnoea, osteoarthritis of knee and quality of life is significant in Indian context.