One-Anastomosis Gastric Bypass (OABG) vs. Single Anastomosis Duodeno-Ileal Bypass (SADI) as revisional procedure following Sleeve Gastrectomy: results of a multicenter study

P. Gallucci, G. Marincola, Francesco Pennestri', P. F. Procopio, F. Prioli, G. Salvi, Luigi Ciccoritti, F. Greco, N. Velotti, V. Schiavone, A. Franzese, F. Mansi, M. Uccelli, G. Cesana, Martina Musella, S. Olmi, Marco Raffaelli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

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.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaLangenbeck's Archives of Surgery
Volume409
DOI
Stato di pubblicazionePubblicato - 2024

Keywords

  • Complications
  • One-Anastomosis Gastric Bypass (OAGB)
  • Recurrence of weight
  • Revisional surgery
  • Single Anastomosis Duodeno-Ileal Bypass (SADI)
  • Suboptimal clinical response

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