Abstract
IntroductionOne anastomosis gastric bypass (OAGB) is an effective and safe treatment for morbidly obese patients. Longer biliopancreatic (BP) limb length is suggested to result in better weight loss outcomes, but to date, no data are available for the OAGB to substantiate this. We hypothesized that applying a longer BP-limb length in the higher BMI classes would result in more weight reduction so that the attained BMI would be comparable to patients with a lower BMI, thereby compensating for differences in baseline BMI.MethodA retrospective cohort study in patients who underwent a primary OAGB at a teaching hospital in the Netherlands between January 2015 and December 2016. BP-limb length was tailored based on preoperative BMI. Patients were divided into three different groups depending on the length of the BP-limb: 150, 180, and 200 cm. Weight loss outcomes after 1 and 3 years and resolution of comorbidities were compared between these groups.ResultsOf the 632 included patients, a BP-limb length of 150 cm was used in 172 (27.2%), 180 cm in 388 (61.4%), and 200 cm in 72 (11.4%) patients. Despite more BMI loss, %EWL was lower and attained BMI remained higher in the groups with longer BP-limb lengths. After adjustment for the confounder preoperative BMI, longer BP-limb lengths were not associated with higher BMI loss. There was no difference in remission rates of comorbidities.ConclusionAttained BMI remained higher in spite of tailoring BP-limb length according to baseline BMI with no differences in remission rates of comorbidities.Graphical
Highlights
One anastomosis gastric bypass (OAGB) is an effective and safe treatment for morbidly obese patients
Compared to the Roux-en-Y gastric bypass (RYGB), the OAGB has one anastomosis instead of two, which translates into technical ease, shorter operation time, and lower complication rates [6, 7]
The current study aimed to investigate the impact of various BP-limb lengths based on preoperative body mass index (BMI) in terms of weight loss and resolution of comorbidities
Summary
One anastomosis gastric bypass (OAGB) is an effective and safe treatment for morbidly obese patients. Some direction to this discussion is given by studies with different limbs lengths to achieve optimal results in terms of weight loss while minimizing the chance of nutritional deficiencies. Some use a fixed length ranging from 150 to 250 cm and some tailor the BP-limb based on patient-related parameters such as initial body mass index (BMI), age, sex, diet, and comorbidities [6,7,8,9,10,11,12]. These subjective variations limit the possibility to compare studies in literature, and hinder consensus on the optimal BP-limb length
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
