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. 2024 Jul;34(7):2399-2410.
doi: 10.1007/s11695-024-07345-8. Epub 2024 Jun 11.

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass-An Experts' Modified Delphi Consensus

Mohammad Kermansaravi  1 , Sonja Chiappetta  2 , Chetan Parmar  3 , Miguel A Carbajo  4 , Mario Musella  5 , Jean-Marc Chevallier  6 , Rui Ribeiro  7 , Almino C Ramos  8 , Rudolf Weiner  9 , Abdelrahman Nimeri  10 , Edo Aarts  11 , Syed Imran Abbas  12 , Ahmad Bashir  13 , Estuardo Behrens  14 , Helmuth Billy  15 , Ricardo V Cohen  16 , Daniel Caina  17 , Maurizio De Luca  18 , Bruno Dillemans  19 , Mathias A L Fobi  20 , Manoel Galvao Neto  21 , Khaled Gawdat  22 , Mohamad Hayssam ElFawal  23 , Kazunori Kasama  24 , Radwan Kassir  25 , Amir Khan  26 , Lilian Kow  27 , Kul Deepak Singh Kular  28 , Muffazal Lakdawala  29 , Laurent Layani  30 , Wei-Jei Lee  31 , Enrique Luque-de-León  32 , Kamal Mahawar  33 , Hazem Almomani  34 , Karl Miller  35 , Juan Carlos Olivares González  36 , Arun Prasad  37 , Karl Rheinwalt  38 , Robert Rutledge  39 , Bassem Safadi  40 , Paulina Salminen  41 , Asim Shabbir  42 , Halit Eren Taskin  43 , Jose Sergio Verboonen  44 , Ramon Vilallonga  45 , Cunchuan Wang  46 , Scott A Shikora  10 , Gerhard Prager  47
Affiliations

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass-An Experts' Modified Delphi Consensus

Mohammad Kermansaravi et al. Obes Surg. 2024 Jul.

Abstract

Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.

Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus.

Results: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300-400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB.

Conclusion: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues.

Keywords: Conversion; Correction; OAGB; Reversal; Revision; Revisional bariatric surgery.

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References

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