Thibaud Bertrand1,2, Claire Rives-Lange1,3, Anne-Sophie Jannot1,4,5,6, Clement Baratte1,2, Flore de Castelbajac1,3, Estelle Lu4, Sylvia Krivan7, Maud Le Gall1,8, Claire Carette1,3, Sebastien Czernichow1,3,9, Jean-Marc Chevallier1,2, Tigran Poghosyan10,11,12. 1. Université de Paris Cité, F-75015, Paris, France. 2. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive, Oncologique Et Bariatrique, Hôpital Européen Georges Pompidou, Paris, France. 3. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France. 4. Assistance Publique-Hôpitaux de Paris (AP-HP), Service d'informatique Médicale, Biostatistiques Et Santé Publique, Hôpital Européen Georges Pompidou, Paris, France. 5. CRC: Inserm, Centre de Recherche Des Cordeliers, Sorbonne Université, Université de Paris Cité, F-75006, Paris, France. 6. INRIA: HeKA, Inria Paris, F-75015, Paris, France. 7. 2Nd Department of General Surgery, Upper Digestive Tract Surgery Center, IASO Group (General Clinic), Athens, Greece. 8. Inserm UMRS 1149, Paris, France. 9. INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Paris, France. 10. Université de Paris Cité, F-75015, Paris, France. tigran.poghosyan@aphp.fr. 11. Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Chirurgie Digestive, Oncologique Et Bariatrique, Hôpital Européen Georges Pompidou, Paris, France. tigran.poghosyan@aphp.fr. 12. Inserm UMRS 1149, Paris, France. tigran.poghosyan@aphp.fr.
Abstract
BACKGROUND: It has been suggested that shortening the length of the biliopancreatic limb (BPL) to 150 cm in one anastomosis gastric bypass (OAGB) would reduce nutritional complication rates without impairing weight loss outcomes. The aim of this study is to compare patients who underwent OAGB with a 200-cm BPL (OAGB-200) to patients with OAGB with a 150-cm BPL (OAGB-150) in terms of weight loss and late morbidity. METHODS: This is a monocentric retrospective matched cohort study including patients with a body mass index between 35 and 50 kg/m2 who underwent an OAGB-150 or an OAGB-200. Patients were matched 1:1 based on age, sex, and body mass index, prior to bariatric surgery. RESULTS: In total, 784 patients who underwent OAGB were included (OAGB-150 n = 392 and OAGB-200 (n = 392). There was no significant difference in terms of early morbidity. Regarding late morbidity in patients with an OAGB-150, significantly lower rates for marginal ulcer (OR = 0.4, CI 95% [0.2; 0.8], p = 0.006), incisional hernia (OR = 0.5, CI 95% [0.3; 1], p = 0.041), and bowel obstruction (OR = 0.3, CI 95% [0.1; 0.9], p = 0.039) were reported. Likewise, regarding late nutritional deficiencies, post-OAGB-150, a significantly lower number of patients with hypoalbuminemia (OR = 0.3, CI 95% [0.2; 0.7], p = 0.006), low vitamin B9 (OR = 0.5, CI 95% [0.2; 1], p = 0.044), and low ferritin (OR = 0.5, CI 95% [0.3; 0.8], p = 0.005) were observed. There was no significant difference in the percentage of excess BMI loss at 1, 2, 3, 4, and 5 years. CONCLUSION: Compared to OAGB-200 in patients with BMI ≤ 50 kg/m2, OAGB-150 results in fewer nutritional deficiency rates long term, without impairing weight loss.
BACKGROUND: It has been suggested that shortening the length of the biliopancreatic limb (BPL) to 150 cm in one anastomosis gastric bypass (OAGB) would reduce nutritional complication rates without impairing weight loss outcomes. The aim of this study is to compare patients who underwent OAGB with a 200-cm BPL (OAGB-200) to patients with OAGB with a 150-cm BPL (OAGB-150) in terms of weight loss and late morbidity. METHODS: This is a monocentric retrospective matched cohort study including patients with a body mass index between 35 and 50 kg/m2 who underwent an OAGB-150 or an OAGB-200. Patients were matched 1:1 based on age, sex, and body mass index, prior to bariatric surgery. RESULTS: In total, 784 patients who underwent OAGB were included (OAGB-150 n = 392 and OAGB-200 (n = 392). There was no significant difference in terms of early morbidity. Regarding late morbidity in patients with an OAGB-150, significantly lower rates for marginal ulcer (OR = 0.4, CI 95% [0.2; 0.8], p = 0.006), incisional hernia (OR = 0.5, CI 95% [0.3; 1], p = 0.041), and bowel obstruction (OR = 0.3, CI 95% [0.1; 0.9], p = 0.039) were reported. Likewise, regarding late nutritional deficiencies, post-OAGB-150, a significantly lower number of patients with hypoalbuminemia (OR = 0.3, CI 95% [0.2; 0.7], p = 0.006), low vitamin B9 (OR = 0.5, CI 95% [0.2; 1], p = 0.044), and low ferritin (OR = 0.5, CI 95% [0.3; 0.8], p = 0.005) were observed. There was no significant difference in the percentage of excess BMI loss at 1, 2, 3, 4, and 5 years. CONCLUSION: Compared to OAGB-200 in patients with BMI ≤ 50 kg/m2, OAGB-150 results in fewer nutritional deficiency rates long term, without impairing weight loss.
Authors: Islam Omar; Miraheal Adadzewa Sam; Maya Elizabeth Pegler; Emma Jane Bligh Pearson; Maureen Boyle; Kamal Mahawar Journal: Obes Surg Date: 2021-02-17 Impact factor: 4.129