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

• Published in: Obesity surgery Vol. 32; no. 2; pp. 256 - 265
• Main Authors: Musella, Mario, Vitiello, Antonio, Susa, Antonio, Greco, Francesco, De Luca, Maurizio, Manno, Emilio, Olmi, Stefano, Raffaelli, Marco, Lucchese, Marcello, Carandina, Sergio, Foletto, Mirto, Pizza, Francesco, Bardi, Ugo, Navarra, Giuseppe, Schettino, Angelo Michele, Gentileschi, Paolo, Sarro, Giuliano, Chiappetta, Sonja, Tirone, Andrea, Berardi, Giovanna, Velotti, Nunzio, Foschi, Diego, Zappa, Marco, Piazza, Luigi
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2022; Springer Nature B.V
• Subjects: 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; OAGB/MGB; Revisional surgery; One anastomosis gastric bypass; Complications; Mini gastric bypass
• ISSN: 0960-8923; 1708-0428; 1708-0428
• DOI: 10.1007/s11695-021-05779-y

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