TY - JOUR
T1 - One-Anastomosis Gastric Bypass (OABG) vs. Single Anastomosis Duodeno-Ileal Bypass (SADI) as revisional procedure following Sleeve Gastrectomy: results of a multicenter study
AU - Gallucci, P.
AU - Marincola, G.
AU - Pennestri', Francesco
AU - Procopio, P. F.
AU - Prioli, F.
AU - Salvi, G.
AU - Ciccoritti, Luigi
AU - Greco, F.
AU - Velotti, N.
AU - Schiavone, V.
AU - Franzese, A.
AU - Mansi, F.
AU - Uccelli, M.
AU - Cesana, G.
AU - Musella, Martina
AU - Olmi, S.
AU - Raffaelli, Marco
PY - 2024
Y1 - 2024
N2 - Purpose: Sleeve Gastrectomy (SG) is the most performed bariatric surgery, but a considerable number of patients may require revisional procedures for suboptimal clinical response/recurrence of weight (SCR/RoW). Conversion options include One-Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Ileal Bypass (SADI). The study aims to compare SADI vs. OAGB as revisional procedures in terms of early and mid-term complications, operative time, postoperative hospital stay and clinical outcomes. Methods: All patients who underwent OAGB or SADI as revisional procedures following SG for SCR/RoW at three high-volume bariatric centers between January 2014 and April 2021 were included. Propensity score matching (PSM) analysis was performed. Demographic, operative, and postoperative outcomes of the two groups were compared. Results: One hundred and sixty-eight patients were identified. After PSM, the two groups included 42 OAGB and 42 SADI patients. Early (≤ 30 days) postoperative complications rate did not differ significantly between OAGB and SADI groups (3 bleedings vs. 0, p = 0.241). Mid-term (within 2 years) complications rate was significantly higher in the OAGB group (21.4% vs. 2.4%, p = 0.007), mainly anastomotic complications and reflux disease (12% of OAGBs). Seven OAGB patients required conversion to another procedure (Roux-en-Y Gastric Bypass—RYGB) vs. none among the SADI patients (p = 0.006). Conclusions: SADI and OAGB are both effective as revisional procedures for SCR/RoW after SG. OAGB is associated with a significantly higher rate of mid-term complications and a not negligible rate of conversion (RYGB). Larger studies are necessary to draw definitive conclusions.
AB - Purpose: Sleeve Gastrectomy (SG) is the most performed bariatric surgery, but a considerable number of patients may require revisional procedures for suboptimal clinical response/recurrence of weight (SCR/RoW). Conversion options include One-Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Ileal Bypass (SADI). The study aims to compare SADI vs. OAGB as revisional procedures in terms of early and mid-term complications, operative time, postoperative hospital stay and clinical outcomes. Methods: All patients who underwent OAGB or SADI as revisional procedures following SG for SCR/RoW at three high-volume bariatric centers between January 2014 and April 2021 were included. Propensity score matching (PSM) analysis was performed. Demographic, operative, and postoperative outcomes of the two groups were compared. Results: One hundred and sixty-eight patients were identified. After PSM, the two groups included 42 OAGB and 42 SADI patients. Early (≤ 30 days) postoperative complications rate did not differ significantly between OAGB and SADI groups (3 bleedings vs. 0, p = 0.241). Mid-term (within 2 years) complications rate was significantly higher in the OAGB group (21.4% vs. 2.4%, p = 0.007), mainly anastomotic complications and reflux disease (12% of OAGBs). Seven OAGB patients required conversion to another procedure (Roux-en-Y Gastric Bypass—RYGB) vs. none among the SADI patients (p = 0.006). Conclusions: SADI and OAGB are both effective as revisional procedures for SCR/RoW after SG. OAGB is associated with a significantly higher rate of mid-term complications and a not negligible rate of conversion (RYGB). Larger studies are necessary to draw definitive conclusions.
KW - Complications
KW - One-Anastomosis Gastric Bypass (OAGB)
KW - Recurrence of weight
KW - Revisional surgery
KW - Single Anastomosis Duodeno-Ileal Bypass (SADI)
KW - Suboptimal clinical response
KW - Complications
KW - One-Anastomosis Gastric Bypass (OAGB)
KW - Recurrence of weight
KW - Revisional surgery
KW - Single Anastomosis Duodeno-Ileal Bypass (SADI)
KW - Suboptimal clinical response
UR - http://hdl.handle.net/10807/303741
U2 - 10.1007/s00423-024-03306-y
DO - 10.1007/s00423-024-03306-y
M3 - Article
SN - 1435-2451
VL - 409
SP - N/A-N/A
JO - Langenbeck's Archives of Surgery
JF - Langenbeck's Archives of Surgery
ER -