IBC-Oxford University2023_BJSPoster_3Mini-Gastric Bypass, One Anastomosis Gastric Bypass, Tailored Biliopancreatic, Bypass vs. Weight Loss

Abstract

Abstract Introduction Studies of different Bariatric procedures have resulted in conflicting findings on the effects of the surgery on daily Dietary Food Choices (DFCs.) Some suggest a pure volume effect, others report changes in type and preferences and still others suggest the effects change over time. The Biliopancreatic Limb (BPL) length in the One Anastomosis Gastric Bypass (OAGB), Mini-Gastric Bypass-Original Technique (MGB-OT) version, includes a "tailored" BPL length. The purpose of this study was to investigate the relationship between BPL length and DFCs in patients undergoing MGB-OT. The primary hypothesis was that the changes in dietary habits and food choices would be related to the BPL length in the MGB-OT. Methods Data from a long term online patient survey including MGB-OT patients were collected including basic demographics, MGB-OT BPL length, patient reported DFCs and weight loss classes. Linear regression modelling was used to assess the relative association between BPL length with various mean patient reported DFCs and a composite model of Food Choices. Results 286 patients had responses for evaluation. Patients with BPL lengths of 3 to 9 ft (92-274cm) were selected. As reported in prior publications, patient reported mean weight loss classes varied linearly related to BPL length. The mean "Bad" Food Choices (BFC) declined from 5.7/day to 2.0/day. The mean composite "Bad" food choices declined from a mean of 2,070 DFCs per year to an estimated 745. There was a strong linear relation between BPL length and the decline in mean "Bad" daily food choices. (y=-0.3x-3, R2 = 0.7, p<0.05.) Conclusions The present study of mean patient reported DFC outcomes following a "Tailored" BPL length in the MGB-OT version of the OAGB declined substantially. The patient dietary food choices for fried foods, sugar sweetened beverages, processed meats and junk foods all declined. These changes were linearly related to the Bilio-pancreatic limb length. In cases of the MGB-OT a longer Bilio-pancreatic Limb Length was associated with greater weight loss and a greater improvement in daily Dietary Food Choices. If confirmed by other studies the possibility of tailoring the power of a bariatric operation based upon BPL length seems like an important advancement in bariatric surgery.