Long-Term Results of One Anastomosis Gastric Bypass: a Single Center Experience with a Minimum Follow-Up of 10 Years

Abstract

Purpose: The purpose of this study was to evaluate the efficacy and safety of the OAGB at least 10 years after surgery.

Material and methods: We retrospectively reviewed our prospectively collected data on consecutive morbid patients with obesity receiving OAGB from January 2005 to December 2007.

Results: A total of 385 patients met the inclusion criteria. The mean follow-up was 149 months. Of all patients, 52% underwent OAGB as a primary procedure and 48% as a revisional procedure. At the 10-year follow-up, the mean body mass index (BMI) was 30.7 ± 11.8, the mean %TWL was 33.4 ± 10.6, and the mean %EWL was 64.1 ± 24.6. We did not find a significant statistical difference in terms of weight loss between primary OAGB and secondary OAGB. In total, 43% of patients achieved a %EWL greater than 75%, while 29% of the patients had an EWL% that was below 50%. All of the comorbidities related to obesity showed a high improvement or fully resolved. Early complications occurred in 9 patients (2.3%), while the overall rate of late complications was 17.1%. Nineteen patients (4.9%) developed an ulcer at the gastrojejunal anastomosis level, nine patients (2.3%) were re-hospitalized for major malnutrition, thirty-eight patients (9.8%) showed a postoperative biliary reflux, and five patients (2.7%) experienced severe anemia, which required several hospitalizations for iron I.V. supplementation.

Conclusion: According to results of the present study, we believe that OAGB has shown to be a technique with a reasonable balance between long-term efficacy and undesirable sequelae.

Keywords: Biliary reflux; Long-term follow-up; Long-term results; Marginal ulcer; One anastomosis gastric bypass.