Joshua P Landreneau1, Juan S Barajas-Gamboa2, Andrew T Strong3, Ricard Corcelles2, Matthew D Kroh4. 1. Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio. Electronic address: landrej@ccf.org. 2. Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates. 3. Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio. 4. Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio; Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Abstract
BACKGROUND: One-anastomosis gastric bypass (OAGB), also known as minigastric bypass, is an increasingly popular bariatric surgery option worldwide. While OAGB offers advantage in terms of procedure time and technical ease, revisional operations to correct complications may be necessary. OBJECTIVES: We aimed to describe the indications and perioperative outcomes for OAGB conversions to Roux-en-Y gastric bypass (RYGB) at a single-referral center. SETTING: Academic hospital, Abu Dhabi, United Arab Emirates. METHODS: All patients undergoing conversion from OAGB to RYGB from February 2016 through September 2018 were retrospectively identified from a prospectively maintained database of revisional bariatric surgeries. RESULTS: Sixteen patients underwent conversion from previous OAGB to RYGB during the study period. The cohort was 62.5% female (n = 10) with a mean age of 40.2 years and median body mass index of 30.7 kg/m2. Indications for conversion included intractable nausea/vomiting (n = 8, 50.0%), biliary reflux (n = 3, 18.8%), weight recidivism (n = 3, 18.8%), and protein-calorie malnutrition (n = 2, 12.5%). Twelve cases (75.0%) were successfully completed with a laparoscopic approach, with 4 cases (25.0%) converted to open. The median length of stay was 5.5 days. Six patients (37.5%) experienced minor and major complications within 30 days of discharge. Fourteen patients (87.5%) were available for follow-up at 6 months, with 100% of these patients reporting resolution of their preoperative symptoms. There were no mortalities. CONCLUSIONS: Data from this largest reported single-center experience demonstrates that conversion of OAGB to RYGB is safe and technically feasible. Further studies and longer-term follow-up are needed to definitively describe outcomes after this revisional bariatric surgery.
BACKGROUND: One-anastomosis gastric bypass (OAGB), also known as minigastric bypass, is an increasingly popular bariatric surgery option worldwide. While OAGB offers advantage in terms of procedure time and technical ease, revisional operations to correct complications may be necessary. OBJECTIVES: We aimed to describe the indications and perioperative outcomes for OAGB conversions to Roux-en-Y gastric bypass (RYGB) at a single-referral center. SETTING: Academic hospital, Abu Dhabi, United Arab Emirates. METHODS: All patients undergoing conversion from OAGB to RYGB from February 2016 through September 2018 were retrospectively identified from a prospectively maintained database of revisional bariatric surgeries. RESULTS: Sixteen patients underwent conversion from previous OAGB to RYGB during the study period. The cohort was 62.5% female (n = 10) with a mean age of 40.2 years and median body mass index of 30.7 kg/m2. Indications for conversion included intractable nausea/vomiting (n = 8, 50.0%), biliary reflux (n = 3, 18.8%), weight recidivism (n = 3, 18.8%), and protein-calorie malnutrition (n = 2, 12.5%). Twelve cases (75.0%) were successfully completed with a laparoscopic approach, with 4 cases (25.0%) converted to open. The median length of stay was 5.5 days. Six patients (37.5%) experienced minor and major complications within 30 days of discharge. Fourteen patients (87.5%) were available for follow-up at 6 months, with 100% of these patients reporting resolution of their preoperative symptoms. There were no mortalities. CONCLUSIONS: Data from this largest reported single-center experience demonstrates that conversion of OAGB to RYGB is safe and technically feasible. Further studies and longer-term follow-up are needed to definitively describe outcomes after this revisional bariatric surgery.