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. 2018 Jan-Mar;14(1):37-43.
doi: 10.4103/jmas.JMAS_198_16.

Impact of biliopancreatic limb length on severe protein-calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass

Kamal Kumar Mahawar  1 , Chetan Parmar  1 , William R J Carr  1 , Neil Jennings  1 , Norbert Schroeder  1 , Peter K Small  1
Affiliations

Impact of biliopancreatic limb length on severe protein-calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass

Kamal Kumar Mahawar et al. J Minim Access Surg. 2018 Jan-Mar.

Abstract

Background: One anastomosis (mini) gastric bypass (OAGB) is believed to be more malabsorptive than Roux-en-Y gastric bypass. A number of patients undergoing this procedure suffer from severe protein-calorie malnutrition requiring revisional surgery. The purpose of this study was to find the magnitude of severe protein-calorie malnutrition requiring revisional surgery after OAGB and any potential relationship with biliopancreatic limb (BPL) length.

Methods: A questionnaire-based survey was carried out on the surgeons performing OAGB. Data were further corroborated with the published scientific literature.

Results: A total of 118 surgeons from thirty countries reported experience with 47,364 OAGB procedures. Overall, 0.37% (138/36,952) of patients needed revisional surgery for malnutrition. The highest percentage of 0.51% (120/23,277) was recorded with formulae using >200 cm of BPL for some patients, and lowest rate of 0% was seen with 150 cm BPL. These data were corroborated by published scientific literature, which has a record of 50 (0.56%) patients needing surgical revision for severe malnutrition after OAGB.

Conclusions: A very small number of OAGB patients need surgical correction for severe protein-calorie malnutrition. Highest rates of 0.6% were seen in the hands of surgeons using BPL length of >250 cm for some of their patients, and the lowest rate of 0% was seen with BPL of 150 cm. Future studies are needed to examine the efficacy of a standardised BPL length of 150 cm with OAGB.

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Conflict of interest statement

There are no conflicts of interest.

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