Evaluation of laparoscopic one-anastomosis gastric bypass as a revisional procedure for failed vertical-banded gastroplasty and adjustable gastric banding compared with laparoscopic Roux-en-Y gastric bypass

Back
ground Vertical-banded gastroplasty (VBG) and adjustable gastric banding (AGB) have been proven to be associated with high rates of weight-loss failure and long-term complications, this necessitates the search for the ideal revisional procedure. The aim of our study is to analyze the surgical outcome of one-anastomosis gastric bypass (OAGB) as a revisional surgery after failed restrictive procedures compared to the surgical outcome of LRYGBP in3years.
Patients and methods
From January 2018 to December 2020, 50 patients with either failed VBG or AGB operations underwent laparoscopic revisional bypass surgeries [33 OAGB and 17 Roux-en-Y gastric bypass (RYGB)], among them, 32 were after failed VBG and 18 were after failed AGB. The medical records, demographic, and surgical details, and outcomes of all patients who underwent revisional procedures were collected and analyzed.
Results
There were 50 patients, 35 females, and 15 males. The primary operation was AGB in 18 cases, VBG in 32 cases. These patients were subjected to laparoscopic OAGB (OAGB group=33 patients) or laparoscopic RYGB (RYGB group=17 patients). In all 18 failed AGB patients, band removal occurred during operation. All operations were completed laparoscopically as one-stage procedure. There were no major complications in all patients. Hospital stays averaged 3.2 days (range, 2–8) for the OAGB group and 4.6 days (range, 3–10) for the RYGB group. At 1 year, the excess weight-loss percentage was about 79.45±35.21% for the OAGB-group patients versus 71.63±35.24% for the RYGB-group patients.
Conclusion
Revisional bariatric procedures are technically challenging and carry a higher risk of postoperative complications than the primary procedures, RYGB was considered as the gold standard for revisional surgery; however, the OAGB achieved excellent success recently with relative simplicity, shorter operative time, and lower complication rates.