Background

With the continued increase in bariatric procedures being performed in the US, a growing percentage are revisions for weight regain after sleeve gastrectomy (LSG) and gastric banding (LAGB). Standard practice in the US involves conversion to Roux-en-Y gastric bypass (RYGB). Internationally, one anastomosis gastric bypass (OAGB) has become a popular and effective alternative. Without the jejuno-jejunal anastomosis, OAGB has reduced potential related long-term complications. The purpose of this study is to compare the short term safety of revision to OAGB versus RYGB.

Methods

Patients who underwent conversion to OAGB from LAGB or LSG for weight regain at a single, academic center from January 2019 to October 2021 were compared to a cohort of BMI, sex, and age matched patients who underwent conversion to RYGB during the same period.

Results

82 patients were included; 41 in each cohort (41 OAGB vs. 41 RYGB). The majority in both groups underwent conversion from LSG (71% vs. 78%). Operative time, estimated blood loss, and length of stay were comparable. There was no difference in 30 day complications (9.8% vs. 12.2%, p=.99) or reoperation rates (7.3% vs. 4.9%, p=.99). Mean weight loss at 1 month was also comparable (7.91 lbs vs 6.36 lbs).

Conclusions

Patients who underwent conversion to OAGB for weight regain had similar operative times, rates of post operative complications, and one month weight loss. While more research is needed, this early data suggests that conversions to OAGB and RYGB result in comparable postoperative safety. Therefore OAGB may present a safe alternative.