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The Effect of Revisional One Anastomosis Gastric Bypass After Sleeve Gastrectomy on Gastroesophageal Reflux Disease, Compared with Revisional Roux-en-Y Gastric Bypass: Symptoms and Quality of Life Outcomes

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Abstract

Background

Gastroesophageal reflux disease (GERD) is common after sleeve gastrectomy (SG). We aimed to evaluate the effect of revisional one anastomosis gastric bypass (OAGB) on GERD, compared with revisional Roux-en-Y gastric bypass (RYGB)

Methods

A retrospective single-center study of a prospectively maintained patient registry (2018–2022). All patients with GERD undergoing OAGB and RYGB after SG were retrieved and included in the study.

Results

Seventy-eight SG patients had conversion to OAGB (n=31) and RYGB (n=47). Baseline characteristics were similar except age (43.8±11.5 vs. 50.3±13.4 years; p=0.03), body mass index (39.9±8.8 vs. 30.6±6 kg/m2; p<0.001), time interval (8±2.7 vs. 6.4±3.4 years; p=0.01), and sleep apnea (29% vs 8.5%; p=0.01), respectively. There was no significant difference between groups in number of patients consuming proton pump inhibitors (70.1% vs. 72.3%; p=0.66), GERD-health-related quality of life (HRQL) score (9.6±7.2 vs. 13.1±8; p=0.06), and pathological endoscopic findings (48.4% vs. 46.8%; p=0.89). Major complication rates were 0% vs. 8.5% (p=0.09). At 32.4 months follow-up, total weight loss was 22%±12.9 and 4.4%±14.6 (p<0.001), GERD resolution 77.4% and 91.9% (p=0.03), HRQL scoring improved to 1.7±4.5 and 1.7±2.7; p=0.94 for OAGB and RYGB, respectively.

Conclusions

SG conversion to RYGB provides better chances for definitive treatment of GERD. OAGB results in good symptom resolution and improved quality of life and may be considered for post-SG GERD treatment. The most appropriate solution should be individualized to each patient.

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Data Availability

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

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Authors and Affiliations

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

    Danit Dayan, Fahim Kanani, Anat Bendayan, 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

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  1. Danit Dayan
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Correspondence to Adam Abu-Abeid.

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

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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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Key Points

• SG conversion to RYGB provides better chances for definitive treatment of GERD.

• OAGB results in good resolution rates or GERD improvement.

• OAGB may be considered in cases of GERD after SG.

• The most appropriate revisional solution should be individualized to each patient.

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Dayan, D., Kanani, F., Bendayan, A. et al. The Effect of Revisional One Anastomosis Gastric Bypass After Sleeve Gastrectomy on Gastroesophageal Reflux Disease, Compared with Revisional Roux-en-Y Gastric Bypass: Symptoms and Quality of Life Outcomes. OBES SURG 33, 2125–2131 (2023). https://doi.org/10.1007/s11695-023-06636-w

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