scholarly journals One Anastomosis Gastric Bypass Versus Long Biliopancreatic Limb Roux-en-Y Gastric Bypass

2022 ◽  
Author(s):  
Mohamed Y. Ibrahim ◽  
Abdelmoneim S. Elshennawy ◽  
Arsany Talaat Saber Wassef ◽  
Ayman Salah ◽  
Ahmed M. Hassan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Weight Reduction ◽  
Body Weight Loss ◽  
One Anastomosis Gastric Bypass ◽  
Excess Body Weight ◽  
Morbidly Obese ◽  
Significant Difference ◽  
Biliopancreatic Limb

Abstract Background Roux-en-Y gastric bypass (RYGB) is one of the most effective bariatric procedures. The study aimed to explore the value of lengthening the biliopancreatic limb (BPL) in RYGB compared to the outcome of one-anastomosis gastric bypass (OAGB). Methods This prospective study included morbidly obese patients divided into two groups. The RYGB group (n = 36) was subjected to long biliary limb Roux-en-Y gastric bypass (LPRYGB), and the OAGB Group (n = 36) had one anastomosis gastric bypass. During follow-up, weight, BMI, percentage of excess body weight loss (%EBWL), resolution of obesity-related comorbidities, and quality of life (QoL) were evaluated. Results There was no significant difference in weight and BMI after 3 and 6 months. At 12-month follow-up, weight loss was significantly higher in the OAGB group. After 12 months, the two groups showed significant improvement of comorbid conditions without significant difference between the two groups. The Qol was significantly higher in the LPRYGB group 3, 6, and 12 months after surgery compared to the OAGB group. Conclusions Extending the BPL length in RYGB to 150 cm is as effective as OAGB in remission of comorbidities, including diabetes. It was also equally effective in weight reduction in the short term. OAGB was more efficient in weight reduction and a significantly faster operation. LPRYGB showed a better QoL of life 1 year after surgery. Graphical abstract

scholarly journals Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

2021 ◽  
Author(s):  
Arnaud Liagre ◽  
Francesco Martini ◽  
Radwan Kassir ◽  
Gildas Juglard ◽  
Celine Hamid ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Severe Obesity ◽  
Postoperative Mortality ◽  
One Anastomosis Gastric Bypass ◽  
Sustained Weight Loss ◽  
Biliopancreatic Limb ◽  
Percentage Excess Weight Loss

Abstract Purpose The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting. Graphical abstract

Remission of Diabetes after Laparoscopic Gastric Bypass

2008 ◽  
Vol 74 (10) ◽  
pp. 948-952 ◽  
Author(s):  
Brian R. Smith ◽  
Marcelo W. Hinojosa ◽  
Kevin M. Reavis ◽  
Ninh T. Nguyen
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Laparoscopic Gastric Bypass ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Body Weight Loss ◽  
Excess Body Weight ◽  
Morbidly Obese ◽  
Remission Of Diabetes

Diabetes is a well-recognized and treatable risk factor for cardiac disease, and one of many comorbidities associated with obesity. The aim of this study was to evaluate the clinical outcome of a cohort of morbidly obese patients with documented diabetes who underwent laparoscopic Roux-en-Y gastric bypass. Fifty-nine patients with sufficient follow-up were included in the study. Mean preoperative duration of diabetes was 68 months. At 1 month postoperatively, mean excess body weight loss was 17 per cent with 29 patients (49%) showing improvement and 21 patients (36%) having remission of their disease. Mean excess body weight loss was 67 per cent at 12 months postoperatively with 25 patients (42%) showing improvement and 34 patients (58%) having remission of diabetes. Mean preoperative fasting blood glucose level decreased from 152 g/dL preoperatively to 100 g/dL at 12 months (P = 0.02), whereas glycosylated hemoglobin decreased from 7.9 per cent to 5.7 per cent, respectively (P < 0.01). Patients with remission of diabetes had a shorter length of condition compared with patients with only improvement (43 vs 103 months, P < 0.01). Weight loss associated with laparoscopic gastric bypass significantly improves diabetes control and results in discontinuation or marked reduction of antidiabetic medications in the majority of patients. Improvement in glucose control occurs as early as 1 month postoperatively.

Weight loss and improvement of lipid profiles in morbidly obese patients after laparoscopic one-anastomosis gastric bypass: 2-year follow-up

2016 ◽  
Vol 31 (1) ◽  
pp. 416-421 ◽  
Author(s):  
Miguel A. Carbajo ◽  
Arlett Fong-Hirales ◽  
Enrique Luque-de-León ◽  
Juan Francisco Molina-Lopez ◽  
Javier Ortiz-de-Solórzano
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Lipid Profiles ◽  
One Anastomosis Gastric Bypass ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Early Outcomes of Laparoscopic Sleeve Gastrectomy (LSG) in Morbidly Obese Patients

2021 ◽  
Vol 15 (7) ◽  
pp. 2269-2271
Author(s):  
Rahmat Ullah Shah ◽  
Adnan Badar ◽  
Hafiz Niamat Ullah ◽  
Sadia Shah ◽  
Sheikh Muhammad Ibqar Azeem ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Weight Loss ◽  
Excess Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Comorbid Conditions

Objective: To determine the early outcomes of laparoscopic sleeve gastrectomy with respect to weight loss and amelioration of comorbid conditions in morbidly obese patients. Study Design: Prospective descriptive study. Place and Duration of Study: MTI-Lady Reading hospital Peshawar and Royal Imperial hospital Swat from January 2018 to January 2020. Materials and Methods: Total thirty-eight morbidly obese patients of either sex with age range of 25-65 years were included in this study. Informed written consent was taken from all the patients and their demographic details such as age, sex and comorbid conditions were recorded. All the patients underwent laparoscopic sleeve gastrectomy. Preoperative and postoperative data such as body mass index, total & excess weight loss and impact on comorbidities were analyzed. Bariatric Analysis and Reporting Outcome System (BAROS) scoring system was used to analyze the outcomes. Follow-up was taken at 1 year post-operatively. Results: Majority were female 25 (65.8%) patients and 13 (34.2%) males with mean age of 45.39±9.64 years. Comorbidities such as hypertension, diabetes mellitus, hyperlipidemia and obstructive sleep apnoea were recorded in 13.2%, 26.3%, 7.9% and 10.53% patients respectively. Mean excess body weight loss (EWL) was 60.25±12.7 kg and mean body mass index loss was 15.14+9.33 kg/m2at 1 year follow up. Postoperative systolic blood pressure improvement was observed in 23 (60.5%) patients. A significant improvement was observed regarding diabetes mellitus (preoperatively mean HbA1C 9.7±5.9 vs postoperatively mean HbA1C 4.42±3.6) p-value <0.001. According to the BAROS score, 5 (13.3%) showed excellent, 14 (36.8%) showed very good, 17 (44.74%) showed good, 2 (5.3%) showed fair and no patient showed poor outcomes. Satisfaction rate among patients was 94.7%. Conclusion: Laparoscopic sleeve gastrectomy is an excellent procedure both in terms of weight loss and amelioration of comorbid conditions in morbidly obese patients. Key words: Sleeve gastrectomy, Laparoscopic, Excess body weight loss, Morbid obesity

Short-Term Results of Single-Anastomosis Gastric Bypass After Failed Sleeve Gastrectomy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Alaa Abbas Sabry ◽  
Karim Sabry Abd-Elsamee ◽  
Mohamed Ibrahim Mohamed ◽  
Mohammed Mohamed Ahmed Abd-Elsalam
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Weight Regain ◽  
Revisional Surgery ◽  
One Anastomosis Gastric Bypass ◽  
Short Term ◽  
Multicenter Studies ◽  
Metabolic Outcomes

Abstract Background It is already known that Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a stand-alone procedure with good short-term results for weight loss. However, in the long-term, weight regain is considered as a complication. Demand for secondary surgery is rising, partly for this reason, but through that study we try to discover the efficacy of conversion of failed sleeve gastrectomy to one anastomosis gastric bypass (OAGB) regarding weight loss and metabolic outcomes. Objective To asses the efficacy and safety of one anastomosis gastric bypass (OAGB) as a conversion surgery post Sleeve Gastrectomy failure as regard weight loss and metabolic outcomes. Patients and Methods This study is a retrospective cohort study which included 20 patients underwent one anastomosis gastric bypass at Ain-Shams University El-Demerdash Hospital, Cairo, Egypt and specialized bariatric center, Cairo, Egypt From February 2019 to July 2019 with 6 months of postoperative follow up till January 2019. Results In this study, we reviewed and analyzed the outcomes from the revision of the SG due to either inadequate weight loss or weight regain to one anastomosis gastric bypass (OAGB) with %EBWL of 6.65% at 1 month, 13.61 % at 3 months and 20.86% at 6 months. Conclusion OAGB appears to be an effective and safe therapeutic technique as a revisional surgery for failed primary SG with good short-term results for treating morbid obesity and its associated comorbidities with a significantly low rate of complications. However the EBWL was less than what is reported after primary OAGB weight. Multicenter studies with larger series of patients and longer term follow up after SG revisions to OAGB are warranted.

scholarly journals P-B02 Does the length of  alimentary limb  make a significant difference  in the weight loss in  Roux en y gastric bypass patients?

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Mayank Bhandari ◽  
Sabyasachi Chowdhary ◽  
Milind Rao ◽  
Gopinath Bussa ◽  
Julie Holm
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Statistical Significance ◽  
Limb Length ◽  
Alimentary Limb ◽  
Significant Difference ◽  
Alimentary Limb Length ◽  
Biliopancreatic Limb ◽  
Group A ◽  
Group B

Abstract Background Roux en Y gastric bypass (RYGB) surgery for morbid obesity is considered as gold standard, but there can be a difference in the length of alimentary and biliopancreatic limb to achieve optimum weight loss. Till now there is no agreed consensus on the ideal limb lengths and their effect on the weight loss. We would like to evaluate the change in the alimentary limb length on the weight loss after the gastric bypass surgery,  as a short to medium term single center study. Methods A retrospective analysis from prospectively maintained   database of 523 patients who underwent RYGB from  2012 till 2018 was done. Patient who had at least a follow up of 2 years(n = 388) were included.  At our center we use alimentary limb of 120 +/- 10 cm for Body Mass Index (BMI) &lt; 40 kg/m2 (group A)  and 150+/-10 cm for the BMI &gt;40 kg/m2  (Group B). The biliopancreatic limb length varies from 50 to 70 cm and this does not change with BMI.  The percentage excess weight(EWL) loss was measured and analyzed  at 1st  and 2nd year post operatively. We used paired t test to check for statistical significance. Results There were 172 patients in Group A and 216 in Group B. The number of females were 330 and  males were 58.   The average age was 44 years .  The mean  preoperative  BMI for the 120 cm limb group was  37.1 kg/m2 and  that for  150 cm limb was 45.3kg/m2. The EWL for the group A at 1 year and 2 year post op was a  Mean and standard deviation  of 79.3% +/- 39.4% and 78.3% +/- 35.2% respectively and for group B was 58.8% +/- 26.6% and 58.6% +/- 23.2% respectively. The difference was statistically significant (p &lt; 0.001) . The analysis and interpretation for metabolic syndrome is yet to be determined.   Conclusions In our study, Increasing the alimentary limb length for higher BMI reduced  EWL. This is consistent with few other publications regarding the same. This has resulted in a  change in our practice namely keeping the length of alimentary limb constant and varying the BP limb length. We will be analyzing  and presenting this data in future.

Characterization of one anastomosis gastric bypass and impact of biliary and common limbs on bile acid and postprandial glucose metabolism in a minipig model

2021 ◽  
Author(s):  
Camille Marciniak ◽  
Oscar Chávez-Talavera ◽  
Robert Caiazzo ◽  
Thomas Hubert ◽  
Lorea Zubiaga ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Glucose Metabolism ◽  
Glucose Homeostasis ◽  
Body Weight Loss ◽  
Metabolic Effects ◽  
One Anastomosis Gastric Bypass ◽  
Alimentary Limb ◽  
The Common

Background/Objectives: The alimentary limb has been proposed to be a key driver of the weight-loss-independent metabolic improvements that occur upon bariatric surgery. However, the One Anastomosis Gastric Bypass (OAGB) procedure, consisting of one long biliary limb and a short common limb, induces stronger beneficial metabolic effects compared to Roux-en-Y Gastric Bypass (RYGB) in humans, despite the lack of an alimentary limb. The aim of this study was to assess the role of the biliary and common limbs in the weight-loss and metabolic effects that occur upon OAGB. Subjects/Methods: OAGB and sham surgery, with or without modifications of the length of either the biliary limb or the common limb, were performed in Gottingen-like minipigs. Weight loss, metabolic changes, and the effects on plasma and intestinal bile acids (BAs) were assessed 15 days after surgery. Results: OAGB significantly decreased body weight, improved glucose homeostasis, increased postprandial GLP-1 and fasting plasma BAs, and qualitatively changed the intestinal BA species composition. Resection of the biliary limb prevented the body weight loss effects of OAGB and attenuated the postprandial GLP-1 increase. Improvements in glucose homeostasis along with changes in plasma and intestinal BAs occurred after OAGB regardless of the biliary limb length. Resection of only the common limb reproduced the glucose homeostasis effects and the changes in intestinal BAs. Conclusions: Our results suggest that the changes in glucose metabolism and BAs after OAGB are mainly mediated by the length of the common limb, whereas the length of the biliary limb contributes to body weight loss.

scholarly journals The Early Results of the Laparoscopic Mini-Gastric Bypass/One Anastomosis Gastric Bypass on Patients with Different Body Mass Index

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mohsen Mahmoudieh ◽  
Behrouz Keleidari ◽  
Naser Afshin ◽  
Masoud Sayadi Shahraki ◽  
Shahab Shahabi Shahmiri ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Vitamin B12 ◽  
Body Mass ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
One Anastomosis Gastric Bypass ◽  
Mini Gastric Bypass

Introduction. Obesity is among the newest health matters that human beings are struggling with. Length of bypassed intestine is important in achievement of most weight loss and least nutritional and absorptive disorders. This study has aimed to assess short-term metabolic and nutritional effects of laparoscopic mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) with a loop bypass length of 180 centimeters (cm) and compare these factors among patients with a body mass index (BMI) of 40–45 and 45–50 kilograms per square meter (kg/m2). Methods. 25 patients were put in group 1 (BMI = 40–45 kg/m2) and 25 patients in group 2 (BMI = 45–50 kg/m2). Patients’ BMI, postoperative weight, excess weight loss, and laboratory tests including fasting blood sugar (FBS), lipid profile, serum iron (Fe), ferritin, total iron-binding capacity (TIBC), 25-OH vitamin D, vitamin B12, liver function tests, and albumin were recorded preoperatively and within 3- and 6-month follow-up. Results. Weight loss and BMI reduction was significantly more in patients with higher BMI level (P=0.007), and excess weight loss was higher in patients with lower preoperative BMI level (P=0.007). Six-month follow-up showed statistically significant reduction in total cholesterol, total triglyceride, Fe, and vitamin B12 among patients with higher BMI level (P value <0.05). Conclusion. Based on this study, 180-cm intestinal bypassed length works for patients with a BMI level of 40–45 and 45–50 kg/m2, according to their significant decrease in weight, BMI, and improving glycolipid profile.

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