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Roux-en-Y Versus One Anastomosis Gastric Bypass as Redo-Operations Following Sleeve Gastrectomy: A Retrospective Study

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Abstract

Background

Aim of this study was to improve knowledge about the best conversional bariatric procedure following sleeve gastrectomy (SG).

Methods

Data of conversional Roux-en-Y gastric bypass (RYGB) and of one anastomosis gastric bypass (OAGB) after SG were collected prospectively and analyzed retrospectively. Weight loss parameters, gastroesophageal reflux disease (GERD) and comorbidities outcomes were recorded.

Results

Total of 123 patients (90 female, mean age 44 ± 0.9 years, mean body mass index (BMI) 42 ± 0.8 kg/m2) had either RYGB (n = 68) or OAGB (n = 55). Perioperative mortality was zero. Mean surgery time was significantly shorter for OAGB (168 ± 7.2 vs. 201 ± 6.8 min). Perioperative complication rates were not significantly (ns) different between RYGB and OAGB. Total body weight loss (TBWL) in RYGB and OAGB was 18 ± 2.2% and 18 ± 1.9% (12 months) and 18 ± 3.0% and 23 ± 2.6% (24 months; ns), respectively. Length of (individualized) biliopancreatic limb (BPL) correlated significantly with weight loss. Remission rates after 12 months of RYGB and OAGB for arterial hypertension (aHt) were 89% and 92%, for obstructive sleep apnea (OSAS) 56% and 82%, for Type 2 diabetes mellitus (T2DM) 100% and 92%, for osteoarthritis 64% and 85% and for GERD 89% versus 87% (ns), respectively. Nutritional deficiencies were comparable in RYGB (n = 11) and OAGB (n = 14) group (ns).

Conclusion

Both RYGB and OAGB are effective conversional procedures after SG, leading to comparable TBWL, BMI-loss and high remission rates of comorbidities including GERD. Significantly shorter operation times were in favor of OAGB. BPL, which was longer in OAGB was significantly related to higher %TBWL and %BMI-loss compared to RYGB.

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Author notes

  1. Karl Peter Rheinwalt and Sandra Schipper have contributed equally to this work.

Authors and Affiliations

  1. Department of Bariatric, Metabolic and Plastic Surgery, St. Franziskus Hospital Cologne, Schoensteinstr. 63, 50825, Cologne, Germany

    Karl Peter Rheinwalt & Andreas Plamper

  2. Department of General, Visceral and Transplantation Surgery, University Hospital of the RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany

    Sandra Schipper, Patrick Hamid Alizai, Andreas Kroh, Sophia Schmitz, Ulf Peter Neumann & Tom Florian Ulmer

  3. Department of Nanomedicine and Theranostics, Institute for Experimental Molecular Imaging, RWTH University Clinic and Helmholtz Institute for Biomedical Engineering, 52074, Aachen, Germany

    Sandra Schipper

  4. Translational Hepatology, Department of Internal Medicine I, University Clinic Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Jonel Trebicka & Maximilian Joseph Brol

  5. Department of Surgery, Whittington Health NHS Trust, London, N19 5NF, UK

    Chetan Parmar

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  1. Karl Peter Rheinwalt
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Correspondence to Karl Peter Rheinwalt.

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This statistical analysis of data has been conducted in accordance with the concerned national research committee.

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Rheinwalt, K.P., Schipper, S., Plamper, A. et al. Roux-en-Y Versus One Anastomosis Gastric Bypass as Redo-Operations Following Sleeve Gastrectomy: A Retrospective Study. World J Surg 46, 855–864 (2022). https://doi.org/10.1007/s00268-021-06424-6

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