One anastomosis gastric bypass versus Roux-en-Y gastric bypass as a revisional bariatric procedure: comparing 1-year postoperative outcomes.

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Pub Date : 2025-01-10 DOI:10.1016/j.soard.2024.12.023

Bradley Schwack, Loic Tchokouani, Akash Gujral, Akshitha Adhiyaman, Megan Jenkins, George Fielding, Christine Ren Fielding

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Abstract

Background: Globally, many surgeons perform varying revisional procedures to convert either a primary sleeve gastrectomy (SG) or laparoscopic adjustable gastric band (LAGB) for the management of recurrent weight gain. There is no consensus on efficacious revision surgery in terms of long-term weight loss and comorbidity management. Nationally, the most common revision procedure is to a Roux-en-Y gastric bypass (RYGB). Internationally, there are other options in frequent use. This includes the one-anastomosis gastric bypass (OAGB). Both RYGB and OAGB have different potential complications and issues but have been very successful in many patients.

Objectives: To assess OAGB and RYGB as revision surgery, differences in weight loss, and nutritional status at approximately 1 year.

Setting: Single university hospital system.

Methods: Patients who underwent OAGB as a revision of SG or LAGB were case matched by age, sex, and primary bariatric procedure to patients who underwent RYGB during January 2019 to October 2022.

Results: This study looked at 113 patients with either a primary SG or LAGB. Fifty-eight patients were converted to OAGB, and 55 patients were converted to RYGB. The OAGB cohort had a greater total body weight loss compared with the RYGB. There were no significant differences in postoperative nutritional values between the groups, except for decreased vitamin B12 levels in the RYGB cohort.

Conclusion: Patients who underwent conversion from either SG or LAGB to OAGB experienced a greater TBWL at 1-year postoperatively compared with those who underwent conversion to RYGB, without difference in nutritional deficiencies.

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