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One Anastomosis Gastric Bypass–Mini Gastric Bypass with Tailored Biliopancreatic Limb Length Formula Relative to Small Bowel Length: Preliminary Results

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Abstract

Background

One Anastomosis Gastric Bypass–Mini Gastric Bypass (OAGB-MGB) is rapidly gaining popularity and is currently being performed by an increasing number of bariatric surgeons worldwide. However, excessive postoperative weight loss and malnutrition still remain a major concern regarding this procedure. The aim of this observational retrospective study was to investigate whether a tailored biliopancreatic limb (BPL) length relative to small bowel length (SBL) is superior to a fixed BPL length of 200 cm in terms of weight loss results and nutritional deficiencies in morbidly obese patients 1 year following OAGB-MGB.

Materials and Methods

Sixty-four patients who underwent OAGB-MGB were divided into two consecutive groups depending on the BPL length used: fixed 200-cm BPL and tailored BPL groups. Anthropometric measurements (%EWL, TWL, %TWL) and nutritional parameters (vitamin A, vitamin D3, vitamin B12, serum iron, serum albumin, total protein) were compared between the two groups at 1-year follow-up.

Results

No statistically significant differences were observed between the patients in two groups in terms of %EWL, TWL, %TWL. The number of patients with deficiencies of vitamin A (p = 0.030), vitamin D3 (p = 0.020), and albumin (p = 0.030) was significantly higher in fixed 200-cm BPL group as compared with tailored BPL group, 1 year following OAGB-MGB. No statistically significant differences were seen between the patients in two groups in terms of vitamin B12, iron, and total protein deficiencies.

Conclusion

Tailoring BPL length by bypassing about 40% of the SBL seems to be safe and effective. According to preliminary results of this study, a tailored BPL length relative to SBL is even likely to be superior to the fixed 200-cm BPL as it is associated with less nutritional deficiencies while providing similar weight loss results. Further randomized studies with larger sample sizes and longer follow-up periods are necessary to confirm the primary results of this study.

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Authors and Affiliations

  1. Department of Human Pathology of Adult and Evolutive Age, University of Messina, Messina, Italy

    Iman Komaei, Federica Sarra, Claudio Lazzara, Giuseppe Navarra & Giuseppe Currò

  2. Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy

    Michele Ammendola, Giuseppe Sammarco & Giuseppe Currò

  3. Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy

    Riccardo Memeo

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  1. Iman Komaei
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Komaei, I., Sarra, F., Lazzara, C. et al. One Anastomosis Gastric Bypass–Mini Gastric Bypass with Tailored Biliopancreatic Limb Length Formula Relative to Small Bowel Length: Preliminary Results. OBES SURG 29, 3062–3070 (2019). https://doi.org/10.1007/s11695-019-04019-8

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