Abstract
BackgroundEfficacy and safety of OAGB/MGB (one anastomosis/mini gastric bypass) have been well documented both as primary and as revisional procedures. However, even after OAGB/MGB, revisional surgery is unavoidable in patients with surgical complications or insufficient weight loss.MethodsA questionnaire asking for the total number and demographics of primary and revisional OAGB/MGBs performed between January 2006 and July 2020 was e-mailed to all S.I.C. OB centres of excellence (annual caseload > 100; 5-year follow-up > 50%). Each bariatric centre was asked to provide gender, age, preoperative body mass index (BMI) and obesity-related comorbidities, previous history of abdominal or bariatric surgery, indication for surgical revision of OAGB/MGB, type of revisional procedure, pre- and post-revisional BMI, peri- and post-operative complications, last follow-up (FU).ResultsTwenty-three bariatric centres (54.8%) responded to our survey reporting a total number of 8676 primary OAGB/MGBS and a follow-up of 62.42 ± 52.22 months. A total of 181 (2.08%) patients underwent revisional surgery: 82 (0.94%) were suffering from intractable DGER (duodeno-gastric-esophageal reflux), 42 (0.48%) were reoperated for weight regain, 16 (0.18%) had excessive weight loss and malnutrition, 12 (0.13%) had a marginal ulcer perforation, 10 (0.11%) had a gastro-gastric fistula, 20 (0.23%) had other causes of revision. Roux-en-Y gastric bypass (RYGB) was the most performed revisional procedure (109; 54%), followed by bilio-pancreatic limb elongation (19; 9.4%) and normal anatomy restoration (19; 9.4%).ConclusionsOur findings demonstrate that there is acceptable revisional rate after OAGB/MGB and conversion to RYGB represents the most frequent choice.Graphical abstract
Highlights
First description of a single anastomosis gastric bypass was reported by Rutledge in 2001 with the definition mini gastric bypass (MGB) [1]
Since many authors use a combination of the two variants, in 2019 the international federation of surgery for obesity (IFSO), during a consensus meeting held in Germany, decided to assign the name “one anastomosis gastric bypass (OAGB)/MGB” as a unique identifier for this procedure [4]
A questionnaire asking for the total number and demographics of primary and revisional OAGB/MGBs performed between January 2006 and July 2020 was e-mailed through S.I.C.OB. to all S.I.C.OB. centres of excellence
Summary
First description of a single anastomosis gastric bypass was reported by Rutledge in 2001 with the definition mini gastric bypass (MGB) [1]. Improvement of comorbidities after OAGB/MGB and a low incidence of complications have been well documented [6]. The increasing utilization of bariatric surgery worldwide [9] has made revisional surgery unavoidable in patients with surgical complications or insufficient weight loss [10, 11], sometimes in an emergency setting, following OAGB/MGB. Revisional surgery after OAGB/MGB is technically feasible but there is a lack of uniformity about indication and type of revision. For these reasons, a multi-institutional survey of S.I.C.OB. A multi-institutional survey of S.I.C.OB. centre of excellence (http://www.sicob.org/0 3_attivita/centri_accreditati_sicob.aspx) was carried out to collect data on number, indications and complication rate and of revisional procedures after OAGB/MGB
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