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Comparison of One Anastomosis Gastric Bypass and Sleeve Gastrectomy for Revision of Laparoscopic Adjustable Gastric Banding: 5-Year Outcomes

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Abstract

Purpose

Laparoscopic adjustable gastric banding (LAGB) is in continuous decline due to low effectiveness and high reoperation rates. This study aims to evaluate outcomes of converting LAGB to one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) for insufficient weight loss or weight regain.

Materials and Methods

Retrospective comparative study, based on prospective registry database of a tertiary center (2012–2019).

Results

In all, 276 LAGB patients were converted to OAGB (n = 125) and SG (n = 151). Body mass index (BMI) at revision was 41.3 ± 6.6 and 42.3 ± 9.6 kg/m2 (P = 0.34) in OAGB and SG patients, respectively. Time interval was longer in OAGB patients (p < 0.001). Major early complication rates were comparable (2.4% and 4%; p = 0.46). At 5-years, OAGB patients had lower BMI (31.9 vs. 34.5 kg/m2; p = 0.002), and a higher total weight loss (25.1% vs. 18.8%; p = 0.003), compared with SG patients. Resolution of type 2 diabetes was higher in OAGB patients (93.3% vs. 66.6%; p = 0.047), while resolution of hypertension was not significantly different (84.6% and 80.5%; p = 0.68). Revision due to delayed complications was required in five (4%) OAGB patients and nine (8.6%) SG patients (p = 0.14).

Conclusion

OAGB for revision after LAGB due to insufficient weight loss or weight regain is safe, and has better effectiveness in weight reduction and resolution of type 2 diabetes than SG.

Graphical Abstract

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

All authors declare that they did not receive any funding or support for this study.

Author information

Authors and Affiliations

  1. Division of General Surgery, Tel Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64230906, Tel Aviv, Israel

    Danit Dayan, Anat Bendayan, Nadav Nevo, Eran Nizri, Guy Lahat & Adam Abu-Abeid

  2. Division of General Surgery, Bariatric Unit, Tel Aviv Sourasky Medical Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Danit Dayan, Guy Lahat & Adam Abu-Abeid

Authors
  1. Danit Dayan
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  2. Anat Bendayan
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  3. Nadav Nevo
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  4. Eran Nizri
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  5. Guy Lahat
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  6. Adam Abu-Abeid
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Corresponding author

Correspondence to Adam Abu-Abeid.

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Informed Consent

Informed consent was obtained from all individuals included in this study.

Ethical Approval

All procedures performed in this study were in accordance with ethical standards of the institutional and/or national health research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All authors declare they have no potential conflicts of interest or financial ties to disclose. No funding was received for this publication.

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Key points

• Revisional OAGB and SG after LAGB are safe.

• Revisional OAGB is superior than SG in terms of weight loss

• Revisional OAGB achieves better resolution rates of T2D than SG

• The rate of revisional surgery during follow-up is similar

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Dayan, D., Bendayan, A., Nevo, N. et al. Comparison of One Anastomosis Gastric Bypass and Sleeve Gastrectomy for Revision of Laparoscopic Adjustable Gastric Banding: 5-Year Outcomes. OBES SURG 33, 1782–1789 (2023). https://doi.org/10.1007/s11695-023-06588-1

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