Comparative study between total bowel measurement and proximal bowel measurement in laparoscopic one-anastomosis gastric bypass regarding effect on weight loss and nutritional status

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Abstract

Background
One-anastomosis gastric bypass (OAGB) is gaining popularity among surgeons for treatment of morbid obesity. Originally, it was comprised of bypassing 200 cm of small bowel, and this produced an incidence of malnutrition of 0.71%. Recent scientific research showed the highly variable length of the human small bowel. In addition, the highest rate of malnutrition was seen with biliopancreatic limb of 250 cm or more. This created a necessity to find more ideal and tailored methods of biliopancreatic limb measurement.
Patients and methods
A prospective randomized study was conducted that included 60 morbidly obese patients who underwent OAGB in the period between January 2019 to January 2021. Patients were randomly assigned into two groups: group A had bypass of 200 cm and group B had total bowel measurement and bypass of one-third of it. They were compared for weight loss and various nutritional parameters.
Results
Excess weight loss (EWL) and mean serum albumin were higher in group B, whereas mean vitamin D level was significantly higher in group A after 6 and 12 months of surgery. No cases of vitamin B1 and B12 were reported during the study period. Mean levels of calcium and iron were insignificantly higher in group B after 6 and 12 months of surgery, but there was no statistically significant difference in nutrient deficiencies between study groups despite a slight advantage for group B.
Conclusion
OAGB with total bowel measurement and bypass of one-third of it produced better weight loss results with less potential for causing malnutrition.

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