Incidence of Dumping Syndrome after Sleeve Gastrectomy, Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass

Background: Dumping syndrome (DS) is an important but often missed problem occurring after bariatric surgery. It is believed that gastric bypass procedures like Roux-en-Y Gastric Bypass (RYGB) and One-Anastomosis Gastric Bypass (OAGB) are more likely to cause DS than the pylorus-preserving Sleeve Gastrectomy (SG). The aim of this study was to evaluate the incidence of DS in patients undergoing SG, RYGB and OAGB. Methods: A retrospective clinical study with additional phone interviews of 180 morbidly obese patients (130 females; 72.2%) undergoing SG (n=50), RYGB (n=53) and OAGB (n=77) in our clinic during 2016 - 2018 was performed. Clinical and demographic data were assessed. The incidence of dumping syndrome was evaluated using validated Sigstad Score. Results: Information about the occurrence of dumping symptoms and patient satisfaction was obtained from 127 patients; 53 could not be reached by phone. Median follow-up was 20.0 ± 11.4 months. Significant differences between the surgical procedures were found for the duration of surgery, complications, incidence of DS and satisfaction postoperatively. DS occurred in 15.6% after SG, in 56.4% after RYGB and in 42.9% after OAGB. While SG showed the shortest operative time with 66.5 ± 25.3 minutes and highest patient satisfaction, the lowest complication rate was observed after OAGB with 5.2%. The RYGB group reported the longest duration of surgery with 121.0 ± 28.9 minutes, most complications (17.0%), and lowest patient satisfaction. Conclusion: The present results showed a clear superiority of SG regarding both perioperative results and incidence of DS compared to RYGB and OAGB and may impact clinicians and patients in their choice of procedure.