Bridged one-anastomosis gastric bypass: technique and preliminary results

Abstract

One-anastomosis gastric bypass (OAGB) is an established bariatric procedure performed worldwide. We developed a modification of OAGB leaving a bridge at the cranial 2 cm of the fundus as a gastro-gastric fistula to allow for endoscopic access to the bypassed stomach. We present the preliminary results of 44 patients who underwent this technique in our hospital. We analyzed, retrospectively, data collected prospectively on 44 patients who underwent our bridged one-anastomosis gastric bypass (BOAGB) procedure between September, 2018 and November, 2020. The mean age of the patients was 45.2\u2009±\u20099.3 years (range 20–66 years). The mean preoperative body mass index (BMI), weight, and HbA1c values were 41.5\u2009±\u20096.4 kg/m2 (range 35–59), 116\u2009±\u200922.7 kg, and 8.2\u2009±\u20092.1%, respectively. After a median follow-up period of 18 months (11–26 months), the mean postoperative BMI was 28.4\u2009±\u20093.2 kg/m2 (range 21–38), the mean total weight loss was 35.8\u2009±\u200913.5 kg (range 20–80 kg), and the mean percentage of excess weight loss (%EWL) and the percentage of total weight loss (%TWL) were 79.8\u2009±\u200916.1% (range 47–109) and 30.6\u2009±\u20096.9% (range 19–48), respectively. The mean postoperative HbA1c level was 6.3\u2009±\u20090.9%. There were two early complications (stenosis and bleeding) and one late complication (marginal ulcer). Patients who underwent BOAGB lost weight similarly to those who underwent OABG as reported in the literature, without an apparent increase in complications related to the technique. Randomized studies with longer term follow-up are needed.