A Systematic Review of One Anastomosis/Mini Gastric Bypass as a Metabolic Operation for Patients with Body Mass Index ≤ 35 kg/m2

Abstract

Background: One anastomosis/mini gastric bypass (OAGB-MGB) is now an established bariatric procedure for patients suffering from obesity. The purpose of this review is to evaluate the role of this operation in patients with body mass index (BMI) ≤ 35 kg/m².

Methods: A literature review was performed as per preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.

Results: This review reports cumulative results of 376 OAGB-MGB procedures with a mean age of 44.28 years and mean BMI of 29.16 kg/m² (range 22-35). Females represented 67.67% of the patients. The leak rate was 0.27%. The mean follow-up was 32.6 months (6-84 months). The mean operative time was 89.45 min. The median limb length was 120 cm (range 100-200 cm). The mean fasting plasma glucose (FPG) decreased from 196.97 to 103.28 mg/dL. The mean HbA1c came down from 9.13% preoperatively to 6.14% postoperatively. The total cholesterol levels came down from a mean of 197.8 mg/dL preoperatively to 120.6 mg/dL postoperatively. The low-density lipoprotein (LDL) and triglyceride levels came down from 127.7 and 209.3 mg/dL to 81 and 94.8 mg/dL, respectively. Mortality was 0%. Marginal ulceration rate of 6.3% and an anaemia rate of 4.7% were reported. Low albumin was reported in 1 (0.2%) patient. The mean BMI came down to 23.76 kg/m² at 12 months.

Conclusions: We conclude that there is now satisfactory evidence to consider OAGB-MGB as a safe and effective metabolic procedure for diabetic patients with BMI ≤ 35 kg/m². Randomised studies comparing different bariatric procedures with longer term follow-up are needed.

Keywords: BMI ≤ 35 kg/m2; Metabolic surgery; Mini gastric bypass; One anastomosis gastric bypass.