Journal Article

Revisional Surgery After One Anastomosis/Minigastric Bypass: an Italian Multi-institutional Survey

Greco, Francesco, Manno, Emilio, Sarro, Giuliano, Berardi, Giovanna, Zappa, Marco, Raffaelli, Marco, Gentileschi, Paolo, Bardi, Ugo, Schettino, Angelo Michele, Olmi, Stefano, Lucchese, Marcello, Carandina, Sergio, Musella, Mario, Susa, Antonio, Piazza, Luigi, Vitiello, Antonio, Tirone, Andrea, Chiappetta, Sonja, De Luca, Maurizio, Velotti, Nunzio, Foschi, Diego, Foletto, Mirto, Pizza, Francesco, Navarra, Giuseppe

2022

Overview

Background Efficacy and safety of OAGB/MGB (one anastomosis/mini gastric bypass) have been well documented both as primary and as revisional procedures. However, even after OAGB/MGB, revisional surgery is unavoidable in patients with surgical complications or insufficient weight loss. Methods A questionnaire asking for the total number and demographics of primary and revisional OAGB/MGBs performed between January 2006 and July 2020 was e-mailed to all S.I.C. OB centres of excellence (annual caseload > 100; 5-year follow-up > 50%). Each bariatric centre was asked to provide gender, age, preoperative body mass index (BMI) and obesity-related comorbidities, previous history of abdominal or bariatric surgery, indication for surgical revision of OAGB/MGB, type of revisional procedure, pre- and post-revisional BMI, peri- and post-operative complications, last follow-up (FU). Results Twenty-three bariatric centres (54.8%) responded to our survey reporting a total number of 8676 primary OAGB/MGBS and a follow-up of 62.42 ± 52.22 months. A total of 181 (2.08%) patients underwent revisional surgery: 82 (0.94%) were suffering from intractable DGER (duodeno-gastric-esophageal reflux), 42 (0.48%) were reoperated for weight regain, 16 (0.18%) had excessive weight loss and malnutrition, 12 (0.13%) had a marginal ulcer perforation, 10 (0.11%) had a gastro-gastric fistula, 20 (0.23%) had other causes of revision. Roux-en-Y gastric bypass (RYGB) was the most performed revisional procedure (109; 54%), followed by bilio-pancreatic limb elongation (19; 9.4%) and normal anatomy restoration (19; 9.4%). Conclusions Our findings demonstrate that there is acceptable revisional rate after OAGB/MGB and conversion to RYGB represents the most frequent choice. Graphical abstract

• Publisher: Springer US,Springer Nature B.V
• Subject: Body mass index / Gastric Bypass - adverse effects / Gastric Bypass - methods / Gastric Fistula - surgery / Gastrointestinal surgery / Humans / Medicine / Medicine & Public Health / Obesity, Morbid - surgery / Original Contributions / Reoperation - methods / Retrospective Studies / Surgery / Surgical outcomes / Surveys and Questionnaires / Weight Loss