Abstract
Abstract Background The number of patients undergoing bariatric surgery for morbid obesity has progressively increased in the last 20 years worldwide. The procedures most performed nowadays are sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), accounting for 46% and 38.2% of all procedures, respectively. Among the other bariatric procedures, one anastomosis gastric bypass (OAGB) has rapidly gained acceptance and diffusion worldwide and represents 7.6% of all bariatric interventions The one anastomosis gastric bypass (OAGB) has currently gained a widespread diffusion among bariatric surgeons, being the third commonest procedure worldwide performed after sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB). OAGB gained many supporters but also several criticisms for the possible onset of biliary reflux and malabsorption with consequent nutritional deficits Objective To find the most optimal length of biliopancreatic limb length in one anastomosis gastric bypass with best weight loss, outcomes and least possible malnutrition. Patients and Methods Out of the included studies, there was five Cohort study, while the remaining studies was RCT. Follow-up periods ranged between one and 12 months to 36 months. Regarding patients’ characteristics, 7343 patients were studied in the included articles. Results The rates of anemia were significantly higher in the long limb procedures due to the reduced capacity to absorb iron. However, we could not find significant differences between long and short limb procedures in the rates of iron deficiency; the small number of studies in such a comparison might have contributed to this finding. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2023. Conclusion While long limb surgery induced significantly higher weight loss than short limb procedures as indicated by %EWL and %TWL, long limb procedures were associated with multiple nutritional deficiencies, including hypoalbuminemia, hypoproteinemia, and hypocalcemia. Additionally, higher proportions of anemia and malnutrition were observed after long limb procedures compared to short limb procedures. The results should be interpreted with caution given the inherent limitations of studies’ design (primarily retrospective investigations) and the small number of studies that assessed nutritional differences over long follow-up periods. Future large- sized RCTs are required to assess the efficacy and safety of long limb procedures on weight loss and nutritional outcomes, considering the roles of BPL length, ethnic variation, gut hormonal response, and the malabsorptive paradigm of gastric bypass surgeries.
Published Version
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 call