Metabolic Effect of the Hepatic Branch of the Vagal Nerve in One-Anastomosis Gastric Bypass (OAGB).

Abstract

Bariatric surgery is often performed not only to lose weight, but also to improve obesity-related comorbidities. A certain metabolic effect of the bariatric techniques has been demonstrated, as the improvement or even remission of comorbidities is patent, before having lost a relevant amount of weight. The autonomic innervation of diverse viscera by the vagus nerve has been hypothesized to participate in it. We aimed to evaluate the ponderal and metabolic impact of the preservation of the hepatic branch of the vagus in type 2 diabetic (T2D) patients undergoing one-anastomosis gastric bypass (OAGB). We conducted a prospective study on patients with a preoperative diagnosis of morbid obesity and T2D, who underwent an OAGB. Preservation of the hepatic branch of the vagus was carried out in the first 14 patients (Group 1), whereas in another 14 patients it was sectioned. Ponderal and metabolic outcomes were assessed 1 and 2years after surgery. The length of the biliary limb was 210cm in both groups. Postoperative BMI or excess BMI loss was not significantly different between groups. The patients included in Group 1 showed a statistically greater improvement in glycemic and lipid variables. The preservation of the hepatic branch of the vagus in an OAGB leads to more favorable postoperative glycemic and lipid profiles.