SP7.1 Effect of gastrojejunal anastomosis diameter in laparoscopic one-anastomosis gastric bypass for the treatment of morbid obesity and related disorders: a comparative study

Abstract

Abstract Background One-anastomosis gastric bypass (OAGB) is a safe and effective bariatric procedure that employs a long gastric pouch with antecolic loop gastrojejunal (GJ) anastomosis. The optimum anastomosis diameter is still unclear, as there are many differences in the literature. Aim This study aims to evaluate the short-term effect of different GJ anastomosis diameters in patients offered laparoscopic OAGB regarding weight loss, bile reflux, and nutritional and metabolic effect. Patients and methods A total of 59 patients were included in this study, and they were divided into two groups: group A included patients with GJ anastomosis made by a 45-mm stapler reload, and group B included patients with GJ anastomosis made by 20 mm of the stapler reload. Results There was no statistically significant difference between groups regarding postoperative mean BMI at 3, 6, 9 months, and 1 year; excess weight loss (EWL%); remission of comorbidities; and bile reflux (P>0.05). Hypoalbuminemia was significantly more evident in group B at 3, 9 months, and 1 year, with P values of less than 0.001, 0.035, and 0.031, respectively. Moreover, group B patients had more iron-deficiency anemia, which was statistically significant at 3, 6, and 9 months (P<0.05), whereas there was no significant difference at 1 year (P=0.128). Conclusion OAGB is an effective bariatric procedure, but the use of a 45-mm stapler reload for GJ anastomosis may be associated with less nutritional deficiencies than using 20 mm of the reload. Further studies are needed on a larger number of patients with long-term follow-up.