Advertisement

Obesity Surgery

, Volume 28, Issue 9, pp 2956–2967 | Cite as

One Anastomosis (Mini) Gastric Bypass Is Now an Established Bariatric Procedure: a Systematic Review of 12,807 Patients

  • Chetan D. ParmarEmail author
  • Kamal K. Mahawar
Review Article
  • 536 Downloads

Abstract

The One Anastomosis (Mini) Gastric Bypass is rapidly gaining acceptance. This review reports cumulative results of 12,807 procedures in obese patients with a mean age of 41.18 years and BMI of 46.6 kg/m2. The overall mortality was 0.10% and the leak rate was 0.96%. The follow-up duration ranged from 6 months to 12 years. A marginal ulceration rate of 2.7% and an anaemia rate of 7.0% were reported. Approximately 2.0% of patients reported postoperative gastro-oesophageal reflux and 0.71% developed malnutrition. Excess weight loss at 6, 12, 24 and 60 months was 60.68, 72.56, 78.2 and 76.6% respectively. Type 2 diabetes mellitus and hypertension resolved in 83.7 and 66.94% respectively. We conclude that there is now sufficient evidence to include MGB-OAGB as a mainstream bariatric procedure.

Keywords

Bariatric surgery Gastric bypass One anastomosis gastric bypass Mini gastric bypass Single anastomosis gastric bypass Omega loop gastric bypass Loop gastric bypass 

Abbreviations

MGB-OAGB

One Anastomosis (Mini) Gastric Bypass

PRISMA

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

EWL

excess weight loss

RCT

randomised controlled trial

RYGB

Roux-en-Y gastric bypass

LAGB

laparoscopic adjustable gastric banding

SG

sleeve gastrectomy

GORD

gastro-oesophageal reflux disease

IDA

iron deficiency anaemia

Notes

Acknowledgements

Harriet Croxton, Librarian, Whittington Hospital.

Author Contributions

KM conceived the idea for the topic. KM and CP participated in literature search. CP collected most of the data and analysed it. CP and KM both contributed to manuscript writing. Both authors have seen the final version and approve of it.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study, ethical approval is not required.

References

  1. 1.
    Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304–8.Google Scholar
  2. 2.
    Deitel M. Letter to the editor: bariatric surgery worldwide 2013 reveals a rise in mini gastric bypass. Obes Surg. 2015;25(11):2165.Google Scholar
  3. 3.
    Mahawar KK, Jennings N, Brown J, et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23(11):1890–8.Google Scholar
  4. 4.
    De Luca M, Tie T, Geraldine O, et al. Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg. 2018:3182–3.Google Scholar
  5. 5.
    British Obesity and Metabolic Surgery Society (BOMSS). http://www.bomss.org.uk/statement-on-mini-gastric-bypass. Last accessed on 10th March 2018.
  6. 6.
    Mahawar KK, Parmar C, Carr WRJ, et al. Impact of biliopancreatic limb length on severe protein–calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass. J Minim Access Surg. 2017;  https://doi.org/10.4103/jmas.JMAS_198_16.
  7. 7.
    Mahawar K, Kular K, Parmar C, et al. Perioperative practices concerning one anastomosis gastric bypass: a survey of 210 surgeons. Obes Surg. 2018;  https://doi.org/10.1007/s11695-017-2831-2.
  8. 8.
    Angrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery and Endoluminal Procedures: IFSO worldwide survey 2014. Obes Surg. 2017;  https://doi.org/10.1007/s11695-017-2666-x.
  9. 9.
    Lee W-J, Lin Y-H. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24(10):1749–56.Google Scholar
  10. 10.
    Lessing Y, Pencovich N, Khatib M, et al. One-anastomosis gastric bypass: first 407 patients in 1 year. Obes Surg. 2017;27:2583–9.  https://doi.org/10.1007/s11695-017-2668-8.Google Scholar
  11. 11.
    Taha O, Abdelaal M, Abozeid M, et al. Outcomes of omega loop gastric bypass, 6-years’ experience of 1520 cases. Obes Surg. 2017;27:1952–60.  https://doi.org/10.1007/s11695-017-2623-8.Google Scholar
  12. 12.
    Meydan C, Raziel A, Sakran N, et al. Single anastomosis gastric bypass-comparative short-term outcome study of conversional and primary procedures. Obes Surg. 2017;27(2):432–8.Google Scholar
  13. 13.
    Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27(5):1153–67.Google Scholar
  14. 14.
    Seetharamaiah S, Tantia O, Goyal G, et al. LSG vs OAGB-1 year follow-up data-a randomized control trial. Obes Surg. 2017;27(4):948–54.Google Scholar
  15. 15.
    Kansou G, Lechaux D, Delarue J, et al. Laparoscopic sleeve gastrectomy versus laparoscopic mini gastric bypass: one year outcomes. Int J Surg. 2016;33:18–22.Google Scholar
  16. 16.
    Plamper A, Lingohr P, Nadal J, et al. Comparison of mini-gastric bypass with sleeve gastrectomy in a mainly super-obese patient group: first results. Surg Endosc. 2017;31(3):1156–62.Google Scholar
  17. 17.
    Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-en-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg. 2016;26(5):926–32.Google Scholar
  18. 18.
    Mokhber S, Nikoyan P, Kabir A, et al. Anaemia outcome after laparoscopic mini bypass : analysis of 107 consecutive patients. Acta Gastro-Enterol Belg. 2016;79(2):201–5.Google Scholar
  19. 19.
    Parmar CD, Mahawar KK, Boyle M, et al. Mini gastric bypass: first report of 125 consecutive cases from United Kingdom. Clin Obes. 2016;6(1):61–7.Google Scholar
  20. 20.
    Peraglie C. Laparoscopic mini-gastric bypass in patients age 60 and older. Surg Endosc. 2016;30(1):38–43.Google Scholar
  21. 21.
    Peraglie C. Laparoscopic mini-gastric bypass (LMGB) in the super-super obese: outcomes in 16 patients. Obes Surg. 2008;18(9):1126–9.Google Scholar
  22. 22.
    Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25(6):951–8.Google Scholar
  23. 23.
    Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surg Obes Relat Dis. 2015;11(2):321–6.Google Scholar
  24. 24.
    Prasad A. Robotic one anastomosis (omega loop/mini) gastric bypass for morbid obesity. J Robot Surg. 2014;8(4):371–4.Google Scholar
  25. 25.
    Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obes Surg. 2014;24(9):1430–5.Google Scholar
  26. 26.
    Disse E, Pasquer A, Espalieu P, et al. Greater weight loss with the omega loop bypass compared to the Roux-en-Y gastric bypass: a comparative study. Obes Surg. 2014;24(6):841–6.Google Scholar
  27. 27.
    Musella M, Susa A, Greco F, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28(1):156–63.Google Scholar
  28. 28.
    Darabi S, Talebpour M, Zeinoddini A, et al. Laparoscopic gastric plication versus mini-gastric bypass surgery in the treatment of morbid obesity: a randomized clinical trial. Surg Obes Relat Dis. 2013;9(6):914–9.Google Scholar
  29. 29.
    Lee W-J, Ser K-H, Lee Y-C, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827–34.Google Scholar
  30. 30.
    Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22(5):697–703.Google Scholar
  31. 31.
    Piazza L, Ferrara F, Leanza S, et al. Laparoscopic mini-gastric bypass: short-term single-institute experience. Updat Surg. 2011;63(4):239–42.Google Scholar
  32. 32.
    Wang W, Wei P-L, Lee Y-C, et al. Short-term results of laparoscopic mini-gastric bypass. Obes Surg. 2005;15(5):648–54.Google Scholar
  33. 33.
    Johnson WH, Fernanadez AZ, Farrell TM, et al. Surgical revision of loop (“mini”) gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007;3(1):37–41.Google Scholar
  34. 34.
    Mahawar KK, Carr WR, Balupuri S, et al. Controversy surrounding ‘mini’ gastric bypass. Obes Surg. 2014;24(2):324–33.Google Scholar
  35. 35.
    Welbourn R, Small P, Finlay, I, Sarela A, Somers S, Mahawar K. Second National Bariatric Surgery Report, United Kingdom. http://www.bomss.org.uk/wp-content/uploads/2014/04/Extract_from_the_NBSR_2014_Report.pdf. Last accessed on 16th July 2017.
  36. 36.
    Mahawar KK, Reed AN, Graham YNH. Marginal ulcers after one anastomosis (mini) gastric bypass: a survey of surgeons. Clin Obes. 2017;7(3):151–6.Google Scholar
  37. 37.
    Mahawar KK. Key features of an ideal one anastomosis/mini-gastric bypass pouch. Obes Surg. 2017;27(6):1630–1.  https://doi.org/10.1007/s11695-017-2673-y.Google Scholar
  38. 38.
    Musella M, Susa A, Manno E, et al. Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg. 2017;27:2956–67.  https://doi.org/10.1007/s11695-017-2726-2. [Epub ahead of print].Google Scholar
  39. 39.
    Mahawar KK, Himpens J, Shikora SA, et al. The first consensus statement on one anastomosis/mini gastric bypass (OAGB/MGB) using a modified Delphi approach. Obes Surg. 2018;28(2):303–12.Google Scholar
  40. 40.
    Tolone S, Cristiano S, Savarino E, et al. Effects of omega-loop bypass on esophagogastric junction function. Surg Obes Relat Dis. 2016 Jan;12(1):62–9.Google Scholar
  41. 41.
    Saarinen T, Räsänen J, Salo J, et al. Bile reflux scintigraphy after mini-gastric bypass. Obes Surg. 2017 Aug;27(8):2083–9.Google Scholar
  42. 42.
    Mahawar KK, Borg CM, Kular KS, et al. Understanding objections to one anastomosis (mini) gastric bypass: a survey of 417 surgeons not performing this procedure. Obes Surg. 2017;27:2222–8.  https://doi.org/10.1007/s11695-017-2663-0.Google Scholar
  43. 43.
    Wu CC, Lee WJ, Ser KH, et al. Gastric cancer after mini-gastric bypass surgery: a case report and literature review. Asian J Endosc Surg. 2013 Nov;6(4):303–6.Google Scholar
  44. 44.
    Kermansaravi M, Abdolhosseini MR, Kabir A, et al. Severe hypoalbuminemia and steatohepatitis leading to death in a young vegetarian female, 8 months after mini gastric bypass: A case report. Int J Surg Case Rep. 2017;31:17–9.Google Scholar
  45. 45.
    Mahawar K. A biliopancreatic limb of >150 cm with OAGB/MGB is ill-advised. Obes Surg. 2017;27(8):2164–5.Google Scholar
  46. 46.
    Kassir R, Blanc P, Lointier P, et al. Laparoscopic revision of an omega loop gastric bypass to treat afferent loop syndrome. Obes Surg. 2015 Oct;25(10):1976–8.  https://doi.org/10.1007/s11695-015-1805-5.Google Scholar
  47. 47.
    Lee W-J, Chong K, Lin Y-H, et al. Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for the treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect. Obes Surg. 2014;24(9):1552–62.Google Scholar
  48. 48.
    Musella M, Apers J, Rheinwalt K, et al. Efficacy of bariatric surgery in type 2 diabetes mellitus remission: the role of mini gastric bypass/one anastomosis gastric bypass and sleeve gastrectomy at 1 year of follow-up. A European survey. Obes Surg. 2016;26(5):933–40.Google Scholar
  49. 49.
    Carbajo MA, Fong-Hirales A, Luque-de-León E, et al. Weight loss and improvement of lipid profiles in morbidly obese patients after laparoscopic one-anastomosis gastric bypass: 2-year follow-up. Surg Endosc. 2017;31(1):416–21.Google Scholar
  50. 50.
    Facchiano E, Iannelli A, Lucchese M. Internal hernia after mini-gastric bypass: myth or reality? J Visc Surg. 2016;153(3):231–2.Google Scholar
  51. 51.
    Genser L, Carandina S, Soprani A. Petersen’s internal hernia complicating a laparoscopic omega loop gastric bypass. Surg Obes Relat Dis. 2015;11(5):e33–4.Google Scholar
  52. 52.
    Kular KS, Prasad A, Ramana B, et al. Petersen's hernia after mini (one anastomosis) gastric bypass. J Visc Surg. 2016;153(4):321.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Whittington HospitalLondonUK
  2. 2.Sunderland Royal HospitalSunderlandUK

Personalised recommendations