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Effect of One Anastomosis Gastric Bypass on Haematinics, Vitamin D and Parathyroid Hormone Levels: a Comparison Between 150 and 200 cm Bilio-Pancreatic Limbs

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Abstract

Introduction

There is little data on the effect of one anastomosis gastric bypass (OAGB) on haematinics, vitamin D and parathyroid hormone levels. It is further unclear if an OAGB with a bilio-pancreatic limb (BPL) of 150 cm (OAGB-150) would deliver better outcomes than that with a BPL of 200 cm (OAGB-200).

Materials and Methods

We investigated our records to obtain information on patients who underwent an OAGB-200 or OAGB-150 until 31st July 2018 in our unit.

Results

A total of 405 patients underwent either an OAGB-200 (n = 234) or OAGB-150 (n = 171). The mean age was 46 ± 10.98 years and 276 (68.1%) were females. The mean preoperative weight and the body mass index (BMI) were 139 ± 29.96 kg and 49 ± 8.14 kg/m2 respectively. With OAGB-200, there was a significant increase in anaemia rates at 1 and 2 years compared to preoperative levels with a significant fall in haemoglobin levels. After OAGB-150, there was a significant fall in haemoglobin levels at 1 and 2 years but the increase in anaemia rate was only significant at 2 years. There was a significant increase in PTH levels and the number of abnormal values at 1 and 2 years with OAGB-200. With OAGB-150, PTH changes were significant at 2 years only.

Conclusion

We found that both OAGB-200 and OAGB-150 are associated with a significant increase in anaemia and secondary hyperparathyroidism. Our findings should prompt the evaluation of supplementation protocols with higher dosages than we recommend for iron, folate and calcium. Consideration should also be given to evaluating shorter BPL lengths than 150 cm with OAGB.

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Authors and Affiliations

  1. Bariatric Unit, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Trust, Sunderland, SR4 7TP, UK

    Islam Omar, Miraheal Adadzewa Sam, Maya Elizabeth Pegler, Emma Jane Bligh Pearson, Maureen Boyle & Kamal Mahawar

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  1. Islam Omar
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  2. Miraheal Adadzewa Sam
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  3. Maya Elizabeth Pegler
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  4. Emma Jane Bligh Pearson
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  5. Maureen Boyle
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  6. Kamal Mahawar
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Contributions

MS, MP, EP and MB collected the data. IO helped with data analysis and wrote most of the manuscript. KM conceived the study, analysed the data and wrote parts of the manuscript. All authors have seen the final manuscript and approve of it.

Corresponding author

Correspondence to Islam Omar.

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Ethics Approval

For this type of study formal ethical approval is not needed.

Statement of Human and Animal Rights

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

Statement of Informed Consent

Informed consent does not apply.

Conflict of Interest

KM has been paid honoraria by Ethicon ®, Medtronic ®, Gore ®, Olympus® and various NHS Trusts for educational activities on one anastomosis gastric bypass. The other authors have no conflicts of interest to declare.

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Omar, I., Sam, M.A., Pegler, M.E. et al. Effect of One Anastomosis Gastric Bypass on Haematinics, Vitamin D and Parathyroid Hormone Levels: a Comparison Between 150 and 200 cm Bilio-Pancreatic Limbs. OBES SURG 31, 2954–2961 (2021). https://doi.org/10.1007/s11695-021-05281-5

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  • DOI: https://doi.org/10.1007/s11695-021-05281-5

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