Care for patients who have undergone one anastomosis gastric bypass surgery

Effect of One Anastomosis Gastric Bypass on Haematinics, Vitamin D and Parathyroid Hormone Levels: a Comparison Between 150 and 200 cm Bilio-Pancreatic Limbs

INTRODUCTION

There is little data on the effect of one anastomosis gastric bypass (OAGB) on haematinics, vitamin D and parathyroid hormone levels. It is further unclear if an OAGB with a bilio-pancreatic limb (BPL) of 150 cm (OAGB-150) would deliver better outcomes than that with a BPL of 200 cm (OAGB-200).

MATERIALS AND METHODS

We investigated our records to obtain information on patients who underwent an OAGB-200 or OAGB-150 until 31st July 2018 in our unit.

RESULTS

A total of 405 patients underwent either an OAGB-200 (n = 234) or OAGB-150 (n = 171). The mean age was 46 ± 10.98 years and 276 (68.1%) were females. The mean preoperative weight and the body mass index (BMI) were 139 ± 29.96 kg and 49 ± 8.14 kg/m² respectively. With OAGB-200, there was a significant increase in anaemia rates at 1 and 2 years compared to preoperative levels with a significant fall in haemoglobin levels. After OAGB-150, there was a significant fall in haemoglobin levels at 1 and 2 years but the increase in anaemia rate was only significant at 2 years. There was a significant increase in PTH levels and the number of abnormal values at 1 and 2 years with OAGB-200. With OAGB-150, PTH changes were significant at 2 years only.

CONCLUSION

We found that both OAGB-200 and OAGB-150 are associated with a significant increase in anaemia and secondary hyperparathyroidism. Our findings should prompt the evaluation of supplementation protocols with higher dosages than we recommend for iron, folate and calcium. Consideration should also be given to evaluating shorter BPL lengths than 150 cm with OAGB.

Areas of Non-Consensus Around One Anastomosis/Mini Gastric Bypass (OAGB/MGB): A Narrative Review

PURPOSE

One anastomosis/mini gastric bypass (OAGB/MGB) is now an established bariatric and metabolic surgical procedure with good outcomes. Despite two recent consensus statements around OAGB/MGB, there are some issues which are not accepted as consensus and need more long-term data and research.

MATERIAL AND METHODS

After identifying the topic of non-consensus from the two recent OAGB/MGB consensuses, PubMed, Scopus, and Cochrane were searched for articles published by November 2020.

RESULTS

In this study, we evaluated these non-consensus topics around OAGB/MGB and all related articles on these topics were assessed by authors to have an argument on these items.

CONCLUSION

There is enough evidence to include OAGB/MGB as an accepted standard bariatric and metabolic surgical procedure. However, long-term data and more research are needed to have a consensus in all aspects including these non-consensus topics.