One Anastomosis Gastric Bypass for Revision of Restrictive Procedures: Mid-Term Outcomes and Analysis of Possible Outcome Predictors

Adam Abu-Abeid*, Or Goren, Subhi Abu-Abeid, Danit Dayan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Revisional one anastomosis gastric bypass (OAGB) for insufficient weight reduction following primary restrictive procedures is still investigated. We report mid-term outcomes and possible outcome predictors. Materials and Methods: Single-center retrospective comparative study of revisional OAGB outcomes (2015–2018) following laparoscopic adjustable gastric banding (LAGB) and sleeve gastrectomy (SG); silastic ring vertical gastroplasty (SRVG) is separately discussed. Results: In all, 203 patients underwent revisional OAGB following LAGB (n = 125), SG (n = 64), and SRVG (n = 14). Comparing LAGB and SG, body mass index (BMI) at revision were 41.3 ± 6.6 and 42 ± 11.2 kg/m2 (p = 0.64), reduced to 31.3 ± 8.3 and 31.9 ± 8.3 (p = 0.64) at mid-term follow-up, respectively. Excess weight loss (EWL) > 50% was achieved in ~ 50%, with EWL of 79.4 ± 20.4% (corresponding total weight loss 38.5 ± 10.4%). SRVG patients had comparable outcomes. Resolution rates of type 2 diabetes (T2D) and hypertension (HTN) were 93.3% and 84.6% in LAGB compared with 100% and 100% in SG patients (p = 0.47 and p = 0.46), respectively. In univariable analysis, EWL > 50% was associated with male gender (p < 0.001), higher weight (p < 0.001), and BMI (p = 0.007) at primary surgery, and higher BMI at revisional OAGB (p < 0.001). In multivariable analysis, independent predictors for EWL > 50% were male gender (OR = 2.8, 95% CI 1.27–6.18; p = 0.01) and higher BMI at revisional OAGB (OR = 1.11, 95% CI 1.03–1.19; p = 0.006). Conclusion: Revisional OAGB for insufficient restrictive procedures results in excellent weight reduction in nearly 50% of patients, with resolution of T2D and HTN at mid-term follow-up. Male gender and higher BMI at revision were associated with EWL > 50% following revisional OAGB. Identification of more predictors could aid judicious patient selection. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)3264-3271
Number of pages8
JournalObesity Surgery
Volume32
Issue number10
DOIs
StatePublished - Oct 2022

Keywords

  • Excess weight loss
  • Laparoscopic adjustable gastric banding
  • Metabolic bariatric surgery
  • One anastomosis gastric bypass
  • Restrictive
  • Revision
  • Silastic ring vertical gastroplasty
  • Sleeve gastrectomy
  • Weight regain

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