SpringerLink
Log in

Conversion of One Anastomosis Gastric Bypass to Roux-en-Y Gastric Bypass: Results of a Retrospective Multicenter Study

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

One anastomosis gastric bypass (OAGB) may expose the patient to certain specific complications. Here, we report the results of conversion of OAGB to Roux-en-Y gastric bypass (RYGB) in terms of outcomes and weight loss.

Methods

Between January 2009 and January 2019, all patients undergoing conversion of OAGB to RYGB because of complications due to OAGB (n = 23) were included. The primary efficacy endpoint was the effectiveness of converting OAGB to RYGB. The secondary endpoints were overall mortality and morbidity during the first 3 postoperative months, specific morbidity, reoperation, length of hospitalization, weight loss, and progression of comorbidities related to obesity at 2-year follow-up.

Results

Indications for conversion were bile reflux (n = 14; 60.9%), severe malnutrition (n = 3; 13%), gastro-gastric fistula (n = 4; 17.4%), and anastomotic leak (n = 2; 8.7%). The median time interval between OAGB and conversion to RYGB was 34 months (0–158). At the time of RYGB, median body mass index (BMI) was 28.0 kg/m2 (18.2–50.7), representing a median BMI change of 14.0 (− 1.7–43.5). Fifteen surgeries (65.1%) were completed laparoscopically. Five complications (21.7%) were recorded, including 2 major ones (8.7%). Reoperation rate was 4.3% (n = 1). At 24 months of follow-up (n = 18; 78.3%), median BMI was 28.7 kg/m2 (19.4–35.4), representing a median BMI change of 19.5 (12.2–43.1). No patient complained of bile reflux or persistent malnutrition.

Conclusion

RYGB performed as revisional surgery for complications after OAGB is an effective procedure with no major weight regain at 2 years of follow-up.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307:56–65.

    Article  Google Scholar 

  2. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  CAS  Google Scholar 

  3. Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11:276–80.

    Article  CAS  Google Scholar 

  4. Robert M, Espalieu P, Pelascini E, et al. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. Lancet. 2019;393:1299–309.

    Article  Google Scholar 

  5. Genser L, Soprani A, Tabbara M, Siksik JM, Cady J, Carandina S. Laparoscopic reversal of mini-gastric bypass to original anatomy for severe postoperative malnutrition. Langenbecks Arch Surg. 2017;402:1263–70.

    Article  Google Scholar 

  6. Chen CY, Lee WJ, Lee HM, et al. Laparoscopic conversion of gastric bypass complication to sleeve gastrectomy: technique and early results. Obes Surg. 2016;26:2014–21.

    Article  Google Scholar 

  7. Johnson WH, Fernanadez AZ, Farrell TM, et al. Surgical revision of loop (“mini”) gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007;3:37–41.

    Article  Google Scholar 

  8. Bolckmans R, Arman G, Himpens J. Efficiency and risks of laparoscopic conversion of omega anastomosis gastric bypass to Roux-en-Y gastric bypass. Surg Endosc. 2019;33:2572–82.

    Article  Google Scholar 

  9. Landreneau JP, Barajas-Gamboa JS, Strong AT, Corcelles R, Kroh MD. Conversion of one-anastomosis gastric bypass to Roux-en-Y gastric bypass: short-term results from a tertiary referral center. Surg Obes Relat Dis. 2019;15:1896–902.

    Article  Google Scholar 

  10. Kassir R, Petrucciani N, Debs T, Juglard G, Martini F, Liagre A. Conversion of one anastomosis gastric bypass (OAGB) to Roux-en-Y gastric bypass (RYGB) for biliary reflux resistant to medical treatment: lessons learned from a retrospective series of 2780 consecutive patients undergoing OAGB. Obes Surg. 2020;30:2093–8.

    Article  Google Scholar 

  11. Cederholm T, Barazzoni R, Austin P, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36:49–64.

    Article  CAS  Google Scholar 

  12. Lönroth H, Dalenbäck J, Haglind E, Lundell L. Laparoscopic gastric bypass. Another option in bariatric surgery. Surg Endosc. 1996;10:636–8.

    Article  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  Google Scholar 

  14. Parmar CD, Mahawar KK. One anastomosis (mini) gastric bypass is now an established bariatric procedure: a systematic review of 12,807 patients. Obes Surg. 2018;28:2956–67.

    Article  Google Scholar 

  15. De Luca M, Tie T, Ooi G, et al. Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg. 2018;28:1188–206.

    Article  Google Scholar 

  16. Carbajo MA, Luque-de-León E, Jiménez JM, Ortiz-de-Solórzano J, Pérez-Miranda M, Castro-Alija MJ. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27:1153–67.

    Article  Google Scholar 

  17. Haddad A, Fobi M, Bashir A, et al. Outcomes of one anastomosis gastric bypass in the IFSO Middle East North Africa (MENA) region. Obes Surg. 2019;29:2409–14.

    Article  Google Scholar 

  18. Ruiz-Tovar J, Carbajo MA, Jimenez JM, et al. Long-term follow-up after sleeve gastrectomy versus Roux-en-Y gastric bypass versus one-anastomosis gastric bypass: a prospective randomized comparative study of weight loss and remission of comorbidities. Surg Endosc. 2019;33:401–10.

    Article  Google Scholar 

  19. Musella M, Susa A, Manno E, et al. Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg. 2017;27:2956–67.

    Article  Google Scholar 

  20. Lee WJ, Ser KH, Lee YC, Tsou JJ, Chen SC, Chen JC. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22:1827–34.

    Article  Google Scholar 

  21. Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15:1304–8.

    Article  Google Scholar 

  22. Gagner M. Hypoabsorption not malabsorption, hypoabsorptive surgery and not malabsorptive surgery. Obes Surg. 2016;26:2783–4.

    Article  Google Scholar 

  23. Keleidari B, Mahmoudieh M, Shahabi S, et al. Reversing one-anastomosis gastric bypass surgery due to severe and refractory hypoalbuminemia. World J Surg. 2020;44:1200–8.

    Article  Google Scholar 

  24. Chaar ME, Lundberg P, Stoltzfus J. Thirty-day outcomes of sleeve gastrectomy versus Roux-en-Y gastric bypass: first report based on Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Surg Obes Relat Dis. 2018;14:545–51.

    Article  Google Scholar 

  25. Khrucharoen U, Juo YY, Chen Y, Dutson EP. Indications, operative techniques, and outcomes for revisional operation following mini-gastric bypass-one anastomosis gastric bypass: a systematic review. Obes Surg. 2020;30:1564–73.

    Article  Google Scholar 

  26. Lee WJ, Lee YC, Ser KH, Chen SC, Chen JC, Su YH. Revisional surgery for laparoscopic minigastric bypass. Surg Obes Relat Dis. 2011;7:486–91.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de Chirurgie Digestive, Oesogastrique Et Bariatrique, Hôpital Bichat Claude Bernard, APHP 7, 75018, Paris, France

    Christos Antonopulos, Lionel Rebibo, Daniela Calabrese & Simon Msika

  2. Université de Paris, Inserm UMR 1149, 75018, Paris, France

    Lionel Rebibo, Daniela Calabrese, Muriel Coupaye, Séverine Ledoux & Simon Msika

  3. Service Des Explorations Fonctionnelles, Centre Intégré de Prise en Charge de L’obésité (CINFO), Hôpital Louis Mourier APHP 7, Colombes Et Université de Paris, 92700, Colombes, France

    Muriel Coupaye & Séverine Ledoux

Authors
  1. Christos Antonopulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lionel Rebibo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniela Calabrese
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Muriel Coupaye
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Séverine Ledoux
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Simon Msika
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simon Msika.

Ethics declarations

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Consent to Participate

Informed consent does not apply.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Key Points

1. Two-center study evaluating conversion of OAGB to RYGB in terms of outcomes and weight loss.

2. Conversion of OAGB to RYGB was not associated with significant increase in weight.

3. Conversion of OAGB to RYGB is effective for correction of severe biliary reflux and malnutrition.

No previous communication to a society or meeting.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Antonopulos, C., Rebibo, L., Calabrese, D. et al. Conversion of One Anastomosis Gastric Bypass to Roux-en-Y Gastric Bypass: Results of a Retrospective Multicenter Study. OBES SURG 32, 1842–1848 (2022). https://doi.org/10.1007/s11695-022-05963-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-022-05963-8

Keywords

Search

Navigation