Initial outcomes of one anastomosis gastric bypass at a single institu

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Wisam Jamal,1 Mohammad M Zagzoog,2 Salma H Sait,2 Ahmed O Alamoudi,2 Shaza Abo’ouf,3 Ayman A Alghamdi,2 Ryan O Bamashmous,2 Ashraf A Maghrabi2

1Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia; 2Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 3Beverly Medical Care Clinics for Obesity Management, Jeddah, Saudi Arabia

Introduction: One anastomosis gastric bypass (OAGB) is an emerging bariatric procedure, which has been reported to be safe and effective. This study aims to evaluate the short-term outcome of OAGB and its midterm effects on weight loss and remission of type 2 diabetes mellitus (T2DM).
Materials and methods: A retrospective review of patients who had undergone OAGB between January 2013 and January 2017 in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, is presented here. Patients’ perioperative characteristics, biochemical profile (fasting blood glucose, HbA1c and iron profile) and details on subsequent weight loss in terms of body mass index (BMI) and excess weight loss percentage (EWL%) along with early and late postoperative complications were evaluated.
Results: Out of the 47 patients who underwent OAGB, 42 were included in this study and completed the 2-year follow-up. Average operative time was 107±21.3  minutes and average length of hospital stay was 2.5±0.53 days. Mean preoperative BMI was 47.6±9.1 kg/m2, and at 1 and 2 years of follow–up, it was 30.5±7.4 and 27.1±5.1, respectively. No mortality, anastomotic leak or bleeding were reported. Most common midterm complication was iron deficiency anemia (n=7/42). Remission of T2DM at 6 months was 80%. Patients with preoperative T2DM for less than 10 years showed better remission (P<0.001).
Conclusion: Our analysis suggests that OAGB is a safe and effective weight loss procedure that carries low perioperative risk and acceptable nutritional complications in the midterm, with a notable remission of T2DM. Preoperative duration of T2DM plays a major role in achieving remission after OAGB.

Keywords: bariatric surgery, weight loss, diabetes mellitus, mini gastric bypass, single anastomosis gastric bypass, omega loop gastric bypass


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