Gastric Bypass after multiple restrictive procedures: Roux-en-Y or One Anastomosis? A retrospective multicentric...

Area of Science:

• Bariatric surgery
• Surgical outcomes
• Weight management

Background:

• Restrictive bariatric procedures can fail, necessitating conversion to malabsorptive techniques.
• Roux-en-Y Gastric Bypass (RYGB) and One Anastomosis Gastric Bypass (OAGB) are common bariatric surgeries.
• Evaluating conversion outcomes after multiple restrictive procedures is crucial for patient management.

Purpose of the Study:

• To compare the weight loss efficacy of RYGB versus OAGB in patients previously treated with multiple restrictive procedures (MRP).
• To assess outcomes specifically for patients experiencing insufficient weight loss (IWL) or weight regain (WR) after prior bariatric surgeries.

Main Methods:

• Retrospective analysis of patients converted from Laparoscopic Sleeve Gastrectomy (LSG) to RYGB or OAGB between 2010-2019.
• Inclusion criteria: conversion for WR or IWL after both Laparoscopic Gastric Banding (LGB) and LSG.
• Study population: 44 patients converted to RYGB and 24 to OAGB.

Main Results:

• One Anastomosis Gastric Bypass (OAGB) demonstrated superior Excess Weight Loss (%EWL) at 3 and 24 months post-conversion compared to Roux-en-Y Gastric Bypass (RYGB).
• At 24 months, OAGB achieved 79.45% %EWL versus 61.8% for RYGB (p=0.046).
• OAGB showed significantly better %EWL for insufficient weight loss (72.7% vs 57.8%, p=0.047), while both techniques performed similarly for weight regain.

Conclusions:

• Both RYGB and OAGB offer good weight loss results at 24 months following multiple restrictive procedures.
• OAGB demonstrates superior efficacy, particularly for patients with insufficient weight loss.
• Longer time intervals between initial restrictive surgery and conversion surgery correlate with better weight loss outcomes.