Tailored One Anastomosis Gastric Bypass: 3-Year Outcomes of 94 Patients

Theodoropoulos, Charalampos; Natoudi, Maria; Vrakopoulou, Gavriella-Zoi; Triantafyllou, Tania; Zografos, Georgios; Leandros, Emmanuel; Albanopoulos, Konstantinos

doi:10.1007/s11695-018-3572-6

Cited by 24 publications

(6 citation statements)

References 22 publications

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“…The surgical technique for OAGB is described in great detail throughout the surgical literature 20 , 21 , and the tailored version that we performed in our department was described in our previously published study 27 .…”

Section: Methodsmentioning

confidence: 99%

Type 2 diabetes mellitus status in obese patients following sleeve gastrectomy or one anastomosis gastric bypass

Vrakopoulou

Theodoropoulos

Kalles

et al. 2021

Sci Rep

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This study aims to compare sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB) in terms of remission of type 2 diabetes mellitus (T2DM) in obese patients. All T2DM patients were followed-up for at least 36 months. The primary outcome was remission of T2DM. Secondary endpoints included weight reduction and the procedure’s impact on quality of life. In total, 53/1177 morbidly obese patients who underwent SG (Group A, n = 28) or OAGB (Group B, n = 25) had T2DM. Preoperatively, the mean Body Mass Index (BMI) values were 52.2 ± 8.5 kg/m2 and 52.9 ± 10.9 kg/m2 for Group A and Group B, respectively. Six patients in Group A were insulin dependent, while 8 were insulin dependent in Group B. After 36 months, diabetes remission was achieved by only 10 patients (35.7%) in Group A. However, in Group B, 22 patients (88%) remained off antidiabetic agents (p < 0.0001), with ΔHbA1c (%) reaching 1.4 ± 1.5% in Group A and 2.7 ± 2.1% in Group B (p = 0.02). Excess weight loss% (%EWL) was again significantly different between the two groups (MA = 79.8 ± 14.5%, MB = 93.3 ± 16.0%, p = 0.003). OAGB is more effective in improving glycaemic control and %EWL, with almost immediate resolution of diabetes, as well as long-term weight loss.

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Section: Methodsmentioning

confidence: 99%

Type 2 diabetes mellitus status in obese patients following sleeve gastrectomy or one anastomosis gastric bypass

Vrakopoulou

Theodoropoulos

Kalles

et al. 2021

Sci Rep

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“…By contrast, Charalampos M. et al did not find any correlations between the BPL length (comparing 200 cm, 250 cm, and 300 cm BPL) and deficiencies after three years [32].…”

Section: Single-anastomosis Duodeno-ileal Bypass With Sleeve Gastrectmentioning

confidence: 83%

Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

Felsenreich

Langer

Eichelter

et al. 2021

JCM

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The number of obese individuals worldwide continues to increase every year, thus, the number of bariatric/metabolic operations performed is on a constant rise as well. Beside exclusively restrictive procedures, most of the bariatric operations have a more or less malabsorptive component. Several different bypass procedures exist alongside each other today and each type of bypass is performed using a distinct technique. Furthermore, the length of the bypassed intestine may differ as well. One might add that the operations are performed differently in different parts of the world and have been changing and evolving over time. This review evaluates the most frequently performed bariatric bypass procedures (and their variations) worldwide: Roux-en-Y Gastric Bypass, One-Anastomosis Gastric Bypass, Single-Anastomosis Duodeno-Ileal Bypass + Sleeve Gastrectomy, Biliopancreatic Diversion + Duodenal Switch and operations due to weight regain. The evaluation of the procedures and different limb lengths focusses on weight loss, remission of comorbidities and the risk of malnutrition and deficiencies. This narrative review does not aim at synthesizing quantitative data. Rather, it provides a summary of carefully selected, high-quality studies to serve as examples and to draw tentative conclusions on the effects of the bypass procedures mentioned above. In conclusion, it is important to carefully choose the procedure and small bowel length excluded from the food passage suited best to each individual patient. A balance has to be achieved between sufficient weight loss and remission of comorbidities, as well as a low risk of deficiencies and malnutrition. In any case, at least 300 cm of small bowel should always remain in the food stream to prevent the development of deficiencies and malnutrition.

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“…Carbajo et al [ 24 ] stated that in OAGB nutritional deficiencies and malnutrition are increasingly reported when the bypassed jejunum is > 250 cm. Charalampos et al [ 25 ] did not find any differences in nutritional deficiencies in OAGB between BP limbs of 200, 250, and 300 cm. IFSO Consensus Conference recommends OAGB to be performed if BMI > 50 with the presence of a suitable length common channel in OAGB if BP is to be more than 200 cm [ 26 ].…”

Section: Discussionmentioning

confidence: 98%

Outcomes and Effects of 250-cm Biliopancreatic Limb One Anastomosis Gastric Bypass in Patients with BMI > 50 kg/m2 with Total Bowel Length > 6 m: a 2-Year Follow-up

Eskandaros

2022

OBES SURG

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Background There is a controversy on the suitable bariatric procedure for patients with BMI > 50 kg/m2. Many surgeons prefer the Roux en-Y gastric bypass (RYGB) while others resort to long biliopancreatic limb (BPL) one anastomosis gastric bypass (OAGB). Methods This study included patients with BMI > 50 kg/m2 who underwent 250-cm BPL OAGB with total bowel length (TBL) > 6 m and completed 24-month follow-up from July 2015 to November 2021. Demographic data with preoperative weight, BMI, hypertension (HTN), DM (HbA1C), Hb, iron, calcium, albumin, vitamin D, and parathormone levels (PTH) were recorded. Operative time, total bowel length (TBL), residual length (RBL), complications and postoperative weight, BMI, % of total weight loss (%TWL), HTN, DM, and alkaline reflux as well as Hb, iron, calcium, albumin, vitamin D, and PTH levels were recorded at 6, 12, 18, and 24 months. Results OAGB had a significant decrease in weight, BMI (25.6 ± 3.4 kg/m2 at 24 months) with %TWL of 48 ± 5% at 24 months. TBL and RBL were 6.7 ± 0.65 and 4.2 ± 0.65 m respectively. %BL (RBL/TBL*100) was 62.4 ± 3.3%. The HbA1C, HTN, and alkaline reflux incidence were 5.5 ± 0.29 gm%, 1.4%, and 3.7% respectively at 24 months. Hb, iron, calcium, albumin, and vitamin D showed a significant decrease but still within normal range, and PTH showed a significant increase at 24 months. Conclusion Long BP (250 cm) OAGB in patients with BMI > 50 kg/m2 with TWL > 6 m had good results in the achievement of weight loss and weight maintenance goals with remission of associated comorbidities as HTN and DM. Graphical abstract

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Tailored One Anastomosis Gastric Bypass: 3-Year Outcomes of 94 Patients

Cited by 24 publications

References 22 publications

Type 2 diabetes mellitus status in obese patients following sleeve gastrectomy or one anastomosis gastric bypass

Type 2 diabetes mellitus status in obese patients following sleeve gastrectomy or one anastomosis gastric bypass

Bariatric Surgery–How Much Malabsorption Do We Need?—A Review of Various Limb Lengths in Different Gastric Bypass Procedures

Outcomes and Effects of 250-cm Biliopancreatic Limb One Anastomosis Gastric Bypass in Patients with BMI > 50 kg/m2 with Total Bowel Length > 6 m: a 2-Year Follow-up

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