EARLY WEIGHT LOSS OUTCOMES AND GLUCOSE METABOLISM PARAMETERS AFTER BANDED VERSUS NON-BANDED ONE ANASTOMOSIS GASTRIC BYPASS: A PROSPECTIVE RANDOMIZED TRIAL

ABSTRACT BACKGROUND: The influence of the placement of a band on the outcomes of one anastomosis gastric bypass (OAGB) has not been appropriately studied yet. OBJECTIVE: To compare early weight loss and glucose metabolism parameters following banded versus non-banded OAGB. METHODS: A prospective randomized study, which evaluated 20 morbidly obese individuals who underwent banded and non-banded OAGB and were followed-up for three months. Weight loss (percentage of excess weight loss - %EWL and percentage of body mass index loss - %BMIL) and glucose metabolism outcomes (glucose, insulin and homeostasis model assessment - HOMA) were compared. RESULTS: The banded group presented a significantly higher %EWL at one month (29.6±5.5% vs 17.2±3.4%; P<0.0001) and two months post-surgery (46±7% vs 34.2±9%; P=0.004544), as well as a significantly higher %BMIL at one month (9.7±1.1% vs 5.8±0.8%; P<0.0001), two months (15±1.4% vs 11.5±2.1; P=0.000248), and three months (18.8±1.8% vs 15.7±3.2%; P=0.016637). At three months, banded OAGB led to significant decreases of insulin (14.4±4.3 vs 7.6±1.9; P=0.00044) and HOMA (3.1±1.1 vs 1.5±0.4; P=0.00044), whereas non-banded OAGB also led to significant decreases of insulin (14.8±7.6 vs 7.8±3.1; P=0.006) and HOMA (3.2±1.9 vs 1.6±0.8; P=0.0041). The percent variation of HOMA did not significantly differ between banded and non-banded OAGB (P=0.62414); overall, the percent variation of HOMA was not correlated with %EWL (P=0.96988) or %BMIL (P=0.82299). CONCLUSION: Banded OAGB led to a higher early weight loss than the standard technique. Banded and non-banded OAGB led to improvements in insulin resistance regardless of weight loss.

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GLP-1 and Adiponectin: Effect of Weight Loss After Dietary Restriction and Gastric Bypass in Morbidly Obese Patients with Normal and Abnormal Glucose Metabolism

Obesity Surgery ◽

10.1007/s11695-008-9678-5 ◽

2008 ◽

Vol 19 (3) ◽

pp. 313-320 ◽

Cited By ~ 45

Author(s):

Camila Puzzi de Carvalho ◽

Daniela Miguel Marin ◽

Aglécio Luiz de Souza ◽

José Carlos Pareja ◽

Elintom Adami Chaim ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Glucose Metabolism ◽

Dietary Restriction ◽

Morbidly Obese ◽

Obese Patients ◽

Abnormal Glucose Metabolism

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

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00356.2020 ◽

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.

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Case Report: Acute kidney failure leading to permanent haemodialysis due to hyperoxaluria following one-anastomosis gastric bypass-related rapid weight loss.

F1000Research ◽

10.12688/f1000research.22109.2 ◽

2020 ◽

Vol 9 ◽

pp. 155

Author(s):

Angelo Miranda ◽

Andrea Rosato ◽

Andrea Costanzi ◽

Lucia Pisano ◽

Sara Colzani ◽

...

Keyword(s):

Weight Loss ◽

Acute Kidney Injury ◽

Gastric Bypass ◽

Renal Function ◽

Kidney Injury ◽

One Anastomosis Gastric Bypass ◽

Rapid Weight Loss ◽

Post Surgery ◽

Key Factor ◽

The One

The one-anastomosis gastric bypass (OAGB) has been proven to provide good weight loss, comorbidity improvement, and quality of life with follow-up longer than five years. Although capable of improving many obesity-related diseases, OAGB is associated with post-operative medical complications mainly related to the induced malabsorption. A 52-year-old man affected by nephrotic syndrome due to a focal segmental glomerulosclerosis underwent OAGB uneventfully. At three months post-surgery, the patient had lost 40kg, reaching a BMI of 32. The patient was admitted to the nephrology unit for acute kidney injury with only mild improvement in renal function (SCr 9 mg/dl); proteinuria was still elevated (4g/24h), with microhaematuria. A renal biopsy was performed: oxalate deposits were demonstrated inside tubules, associated with acute and chronic tubular and interstitial damage and glomerulosclerosis (21/33 glomeruli). Urinary oxalate levels were found to be elevated (72mg/24h, range 13-40), providing the diagnosis of acute kidney injury due to hyperoxaluria, potentially associated to OAGB. No recovery in renal function was observed and the patient remained dialysis dependent. Early and rapid excessive weight loss in patients affected by chronic kidney insufficiency could be associated with the worsening of renal function. Increased calcium oxalate levels associated with OAGB-related malabsorption could be a key factor in kidney injury.

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

Surgical Endoscopy ◽

10.1007/s00464-016-4990-y ◽

2016 ◽

Vol 31 (1) ◽

pp. 416-421 ◽

Cited By ~ 20

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

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

Obesity Surgery ◽

10.1007/s11695-021-05874-0 ◽

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

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Central Noradrenergic Neurotransmission and Weight Loss 6 Months After Gastric Bypass Surgery in Patients with Severe Obesity

Obesity Surgery ◽

10.1007/s11695-021-05657-7 ◽

2021 ◽

Author(s):

J. Marvin Soeder ◽

Julia Luthardt ◽

Michael Rullmann ◽

Georg A. Becker ◽

Mohammed K. Hankir ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Severe Obesity ◽

Occipital Cortex ◽

Brain Regions ◽

General Tendency ◽

Strong Positive Correlation ◽

Reference Tissue ◽

Efficient Treatment ◽

Post Surgery

Abstract Purpose Roux-en-Y gastric bypass (RYGB) surgery is currently the most efficient treatment to achieve long-term weight loss in individuals with severe obesity. This is largely attributed to marked reductions in food intake mediated in part by changes in gut-brain communication. Here, we investigated for the first time whether weight loss after RYGB is associated with alterations in central noradrenaline (NA) neurotransmission. Materials and Methods We longitudinally studied 10 individuals with severe obesity (8 females; age 43.9 ± 13.1 years; body mass index (BMI) 46.5 ± 4.8 kg/m2) using (S,S)-[11C]O-methylreboxetine and positron emission tomography to estimate NA transporter (NAT) availability before and 6 months after surgery. NAT distribution volume ratios (DVR) were calculated by volume-of-interest analysis and the two-parameter multilinear reference tissue model (reference region: occipital cortex). Results The participants responded to RYGB surgery with a reduction in BMI of 12.0 ± 3.5 kg/m2 (p < 0.001) from baseline. This was paralleled by a significant reduction in DVR in the dorsolateral prefrontal cortex (pre-surgery 1.12 ± 0.04 vs. post-surgery 1.07 ± 0.04; p = 0.019) and a general tendency towards reduced DVR throughout the brain. Furthermore, we found a strong positive correlation between pre-surgery DVR in hypothalamus and the change in BMI (r = 0.78; p = 0.01). Conclusion Reductions in BMI after RYGB surgery are associated with NAT availability in brain regions responsible for decision-making and homeostasis. However, these results need further validation in larger cohorts, to assess whether brain NAT availability could prognosticate the outcome of RYGB on BMI. Graphical abstract

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

Obesity Surgery ◽

10.1007/s11695-021-05499-3 ◽

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

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

QJM ◽

10.1093/qjmed/hcab097.039 ◽

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.

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