The IFSO Worldwide One Anastomosis Gastric Bypass Survey: Techniques and Outcomes?

Autor: Haddad A; Minimally Invasive & Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC) -Jordan Hospital, Queen Noor St., 4th Circle, P.O BOX 3073, Amman, 11181, Jordan. drajhaddad@gmail.com., Bashir A; Minimally Invasive & Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC) -Jordan Hospital, Queen Noor St., 4th Circle, P.O BOX 3073, Amman, 11181, Jordan., Fobi M; Clinical Affairs and Research, Mohak Bariatric and Robotics, Indore, India., Higa K; Advanced Laparoscopic Surgery Associates, University of California San Francisco-Fresno, Fresno Heart and Surgical Hospital, Fresno, CA, USA., Herrera MF; Endocrine and Bariatric Surgery, UNAM at INCMNSZ, Mexico City, México., Torres AJ; General and Bariatric Surgery, Complutense University of Madrid, Hospital Clinico 'San Carlos', Madrid, Spain., Himpens J; Metabolic-Bariatric Surgery, CHIREC Delta Hospital, Brussels, Belgium.; St Pierre University Hospital, Brussels, Belgium., Shikora S; Harvard Medical School, Center for Metabolic and Bariatric Surgery, Brigham and Women's Hospital, Boston, MA, USA., Ramos AC; Gastro-Obeso-Center Institute of Metabolic Optimization, Bela Vista, São Paulo, SP, Brazil., Kow L; Adelaide Bariatric Centre, 12 The Parade, Norwood, SA, 5067, Australia., Nimeri AA; Atrium Health Weight Management, Carolinas Medical Center, Charlotte, NC, USA.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2021 Apr; Vol. 31 (4), pp. 1411-1421. Date of Electronic Publication: 2021 Jan 31.
DOI: 10.1007/s11695-021-05249-5
Abstrakt: Introduction: One anastomosis gastric bypass (OAGB) has become one of the most commonly performed gastric bypass procedures in some countries.
Objectives: To assess how surgeons viewed the OAGB, perceptions, indications, techniques, and outcomes, as well as the incidence of short- and long-term complications and how they were managed worldwide.
Methods: A questionnaire was sent to all IFSO members in all 5 chapters to study the pattern of practice and outcomes of OAGB.
Results: Seven hundred and forty-two surgeons responded. The most commonly performed procedures were sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and OAGB. Preoperatively, 70% of the surgeons performed endoscopy routinely. In regards to weight loss, 83% (570 surgeons) responded that OAGB produces better weight loss than SG, and 49% (342 surgeons) responded that OAGB produces better weight loss than RYGB. The most common length of the biliopancreatic limb (BPL) utilized was 200 cm. Sixty-seven percent of surgeons did not measure the total length of the small bowel. In patients with reflux disease and history of smoking, 53% and 22% of surgeons respectively still offered OAGB as a treatment option. Postoperatively, leak was documented in 963 patients, and it was the leading cause for mortality. Leak management was conservative in 35%. Conversion to RYGB was performed in 31%. In 16% the anastomosis was reinforced, 6% of the patients were reversed, and other procedures were performed in 12%. Revision of OAGB for malnutrition/steatorrhea or severe bile reflux was reported at least once by 37% and 45% of surgeons, respectively (200 cm was the most commonly encountered biliopancreatic limb BPL in those revised for malnutrition). Most common strategy for revision was conversion to RYGB (43%), reversal to normal anatomy (32%), shortening of the BPL (20%), and conversion to SG (5%). Nevertheless, 5 out of 98 mortalities (5%) were due to liver failure/malnutrition.
Conclusion: There are infrequent but potentially severe specific complications including malnutrition, liver failure, and bile reflux that may require surgical correction after OAGB.
Databáze: MEDLINE
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