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One Anastomosis Gastric Bypass Performed with a 150-cm Biliopancreatic Limb Delivers Weight Loss Outcomes Similar to Those with a 200-cm Biliopancreatic Limb at 18 -24 Months

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Abstract

Background

It has been suggested that shortening the biliopancreatic limb (BPL) length with one anastomosis gastric bypass (OAGB) to 150 cm would reduce the revision rates for malnutrition. But, it remains unclear if this would not compromise the efficacy of this procedure.

Methods

We examined our prospectively maintained database to compare the outcomes of patients who had their OAGB performed with a 150-cm BPL with those performed with a 200-cm BPL.

Results

Medium-term weight loss data at 18–24 months was available for 343/398 (86.1% follow-up) patients. Of these, 225 had undergone OAGB-200 and 118 had undergone OAGB-150. The mean preoperative weight and body mass index were 141.6 ± 32.8 kg and 49.76 ± 8.6 kg/m2, respectively, in the OAGB-200 group compared with 133.7 ± 24.5 kg and 47.83 ± 7.2 kg/m2, respectively, in the OAGB-150 group. There was no significant difference in albumin and haemoglobin levels in the two groups at 18-month follow-up. The mean excess weight loss was 75.0% ± 20.1 in the OAGB-200 group and 74.0% ± 22.0 in the OAGB-150 group (p = 0.6714). A total of 89.7% (n = 202) patients achieved an excess weight loss (EWL) of ≥ 50.0% in the OAGB-200 group compared with 85.5% (n = 103) in the OAGB-150 group (p value = 0.4754). The mean total weight loss was 36.1% ± 9.2 in the OAGB-200 group compared with 34.0% ± 9.8 in the OAGB-150 group (p value = 0.0598).

Conclusions

OAGB performed with a BPL of 150 cm delivers weight loss outcomes similar to that seen with a BPL of 200 cm.

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Abbreviations

OAGB:

one anastomosis gastric bypass

RYGB:

Roux-en-Y gastric bypass

BPL:

biliopancreatic limb

OAGB-200:

one anastomosis gastric bypass with a 200-cm biliopancreatic limb

OAGB-150:

one anastomosis gastric bypass with a 150-cm biliopancreatic limb

BMI:

body mass index

EWL:

excess weight loss

TWL:

total weight loss

AL:

alimentary limb

BPD:

biliopancreatic diversion

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Acknowledgements

The authors would like to acknowledge the help of Lucy Thompson in data collection.

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Authors and Affiliations

  1. Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK

    Maureen Boyle & Kamal Mahawar

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  1. Maureen Boyle
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Contributions

MB collected the data, analysed it, and helped with manuscript writing. KM conceived the study and wrote most of the manuscript. Both authors participated in the discussions on the topic. Both authors have seen the final manuscript and approved of it.

Corresponding author

Correspondence to Kamal Mahawar.

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Conflict of Interest

KM attended the IFSO consensus conference on this procedure sponsored by the Ethicon and has been paid honoraria by Ethicon®, Medtronic®, Gore®, Olympus®, and various NHS Trusts for educational activities.

Statement of Human and Animal Rights

Not applicable for an audit of a routine procedure in our unit.

Statement of Informed Consent

For this type of audit of data, formal consent is not required.

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Boyle, M., Mahawar, K. One Anastomosis Gastric Bypass Performed with a 150-cm Biliopancreatic Limb Delivers Weight Loss Outcomes Similar to Those with a 200-cm Biliopancreatic Limb at 18 -24 Months. OBES SURG 30, 1258–1264 (2020). https://doi.org/10.1007/s11695-019-04359-5

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