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One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm: Weight Loss, Nutritional Outcomes, Endoscopic Results, and Quality of Life at 8-Year Follow-Up

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A Correction to this article was published on 13 April 2021

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Abstract

Purpose

One anastomosis gastric bypass (OAGB) is now recognized as a mainstream bariatric procedure, nonetheless concerns about the risk of nutritional deficiencies and biliary reflux persist, and the ideal length of the biliopancreatic limb (BPL) is debated.

Materials and Methods

Data of patients who underwent OAGB between May 2010 and December 2010 were collected prospectively and analyzed retrospectively. At an 8-year follow-up, a complete evaluation included clinical examination, blood tests, upper gastrointestinal endoscopy, and quality of life (QoL) assessed through the BAROS score.

Results

Overall, 115 patients underwent OAGB with a BPL of 150 cm. Thirty-six (31%) were lost at the 8-year follow-up. Mean preoperative weight was 117 ± 20.8 kg and mean BMI 43.2 ± 5.8 kg/m2. At 8 years, weight was 76.5 ± 17.3 kg, BMI 28.3 ± 5.8, %TWL 34.8 ± 10.7, and %EWL 84.8 ± 27.1. No patients were readmitted for nutritional complications or underwent revisional surgery for malnutrition; 6 patients were converted to Roux-en-Y gastric bypass for intractable reflux. High rates of vitamin D and A deficiencies and secondary hyperparathyroidism were found at 8 years. The BAROS score was > 3 at 8 years for 93% of patients. Upper gastrointestinal endoscopy was available for 46 patients and found esophagitis in 6.5% of cases but no cases of Barrett’s esophagus.

Conclusion

OAGB performed with a 150-cm BPL is an effective bariatric procedure, associated with good long-term outcomes in relation to weight loss, QoL, resolution of comorbidities, and a very low rate of protein-calorie malnutrition. Fat-soluble vitamin deficiencies represent the main long-term concern. Endoscopic findings at 8 years are reassuring.

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Authors and Affiliations

  1. Service de Chirurgie bariatrique, Ramsay Générale de Santé, Clinique des Cedres, Cornebarrieu, France

    Arnaud Liagre, Gildas Juglard, Mael Chalret du Rieu & Francesco Martini

  2. Division of Digestive Surgery, Archet II Hospital, Nice, France

    Tarek Debs & Niccolo Petrucciani

  3. Department of Digestive Surgery, CHU Félix Guyon, Saint Denis, La Réunion, France

    Radwan Kassir

  4. Service de Gastroenterologie, Ramsay Générale de Santé, Clinique des Cedres, Cornebarrieu, France

    Alain Ledit

  5. Department of General Surgery, Centre Hospitalier Intercommunal de Créteil, Créteil, France

    Andrea Lazzati

  6. Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, Sapienza University, via di Grottarossa 1035-9, 00189, Rome, Italy

    Niccolo Petrucciani

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  1. Arnaud Liagre
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Liagre, A., Debs, T., Kassir, R. et al. One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm: Weight Loss, Nutritional Outcomes, Endoscopic Results, and Quality of Life at 8-Year Follow-Up. OBES SURG 30, 4206–4217 (2020). https://doi.org/10.1007/s11695-020-04775-y

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