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Meta-Analysis
. 2023 May 1;109(5):1497-1508.
doi: 10.1097/JS9.0000000000000346.

Management of leaks following one-anastomosis gastric bypass: an updated systematic review and meta-analysis of 44 318 patients

Mohammad Kermansaravi  1   2 , Radwan Kassir  3   4 , Rohollah Valizadeh  5   6 , Chetan Parmar  7 , Amir Hossein Davarpanah Jazi  6 , Shahab Shahabi Shahmiri  5 , Marine Benois  4
Affiliations
Meta-Analysis

Management of leaks following one-anastomosis gastric bypass: an updated systematic review and meta-analysis of 44 318 patients

Mohammad Kermansaravi et al. Int J Surg. .

Abstract

Introduction: One-anastomosis gastric bypass (OAGB) complication, such as leakage, can be dangerous and should be managed properly, yet little data exist in the literature regarding the management of leaks after OAGB, and there are no guidelines to date.

Methods: The authors performed a systematic review and meta-analysis of the literature and 46 studies, examining 44 318 patients were included.

Results: There were 410 leaks reported in 44 318 patients of OAGB published in the literature, which represents a prevalence of 1% of leaks after OAGB. The surgical strategy was very variable among all the different studies; 62.1% of patients with leaks had to undergo another surgery due to the leak. The most commonly performed procedure was peritoneal washout and drainage (with or without T-tube placement) in 30.8% of patients, followed by conversion to Roux-en-Y gastric bypass in 9.6% of patients. Medical treatment with antibiotics, with or without total parenteral nutrition alone, was conducted in 13.6% of patients. Among the patients with the leak, the mortality rate related to the leak was 1.95%, and the mortality due to the leak in the population of OAGB was 0.02%.

Conclusion: The management of leaks following OAGB requires a multidisciplinary approach. OAGB is a safe operation with a low leak risk rate, and the leaks can be managed successfully if detected in a timely fashion.

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Conflict of interest statement

The authors declare no conflicts of interest.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Forest plot showing the prevalence of leaks among the different studies included in the meta-analysis. ES, effect size.
Figure 3
Figure 3
Forest plot showing the prevalence of leak across only primary and revision studies. ES, effect size.
Figure 4
Figure 4
Diagnostic approach of leak after OAGB. CT, computed tomography; OAGB, one-anastomosis gastric bypass.
Figure 5
Figure 5
Suggested algorithm regarding the management of patients with a suspicion of the leak. CT, computed tomography; R/O, rule out; RYGB, Roux-en-Y gastric bypass.
See this image and copyright information in PMC

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