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Short- and Mid-term Outcomes of 527 One Anastomosis Gastric Bypass/Mini-Gastric Bypass (OAGB/MGB) Operations: Retrospective Study

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Abstract

Background

One anastomosis gastric bypass/mini-gastric bypass (OAGB/MGB) is considered an alternative option in metabolic and bariatric surgery. The aim of this study was to evaluate the safety, efficacy and postoperative challenges of OAGB/MGB as a new procedure.

Methods

We performed 519 primary MGBs and 8 additional second-stage MGBs during 2014–2018. The data were collected from patients’ notes as well as the surgeons’ prospective data sheets. Two senior surgeons performed the operations. The ultimate primary measures were assessment of the safety and management of the complications. The secondary outcomes were excess weight loss and resolution of the comorbidities.

Results

The type 2 diabetes mellitus (T2DM) remission rate was 83% and 70% over 1 and 3 years, respectively (HBA1C < 6.5%). Weight loss was 28–152 kg (SD 23.11). Excess weight loss ranged from 41 to 125%. Hypertension resolution was 61%, 58% and 58% in the first, second and third years, respectively. Ninety-nine per cent of sleep apnoea patients improved symptomatically and went off the continuous positive airway pressure (CPAP) machine. Two (0.37%) patients developed diarrhoea, cured by shortening the afferent biliopancreatic limb (BPL). Eight (1.5%) stomal ulcers were reported. Two patients (0.37%) developed deranged liver function, revised by shortening the BPL in one patient and a reversal in the second patient. The mean follow-up was 2.5 years. Mortality was zero.

Conclusions

This is the largest UK OAGB/MGB study to date showing safety and acceptable results for metabolic syndrome and obesity problems. OAGB/MGB revisional options are rectifying the morbidity and no mortality.

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Authors and Affiliations

  1. Doncaster Royal Infirmary, Doncaster and Bassetlaw Teaching Hospitals, Doncaster, DN2 5LT, UK

    A. Hussain

  2. King’s College Hospitals, London, UK

    S. EL-Hasani

Authors
  1. A. Hussain
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  2. S. EL-Hasani
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Correspondence to A. Hussain.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

A Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Video 1

hand sewn gastro-jejunostomy anastomosis (MOV 17035 kb)

Video 2

stapled gastro-jejunostomy anastomosis (MOV 35141 kb)

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Hussain, A., EL-Hasani, S. Short- and Mid-term Outcomes of 527 One Anastomosis Gastric Bypass/Mini-Gastric Bypass (OAGB/MGB) Operations: Retrospective Study. OBES SURG 29, 262–267 (2019). https://doi.org/10.1007/s11695-018-3516-1

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