Evaluation of Laparoscopic Banded One-Anastomosis Gastric Bypass (LB-OAGB); A Retrospective Study

Abstract Background Laparoscopic one anastomosis gastric bypass (L-OAGB) is a relatively new procedure for the treatment of morbid obesity and related comorbidities. On average, this procedure results in good postoperative weight loss with a low complication rate. Recent publications suggest that dumping syndrome and weight regain might be reduced by placing a silicone ring over the gastric pouch during the procedure, so called laparoscopic banded one anastomosis gastric bypass (LB- OAGB). Objective To evaluate the outcomes of the LB-OAGB as regards efficacy and safety in a 12-month postoperative follow up period. Patients and Methods This is a descriptive retrospective study conducted in Ain Shams University Hospitals, including 20 patients. They were examined and investigated for weight loss after 1, 6 and 12 months, postoperative complications, comorbidities resolution and malnutrition after 6 months. Results 14 Female and 6 male patients were included with a mean age of 38.7 years (24–58), mean preoperative body mass index of 46.221 kg/m2 (39.2–56), and mean preoperative weight of 132.5 kg (112–160). 7 patients presented with type 2 diabetes (35%), 5 patients (25%) diagnosed with hypertension and 1 (5%) patient with hyperlipidemia were included. No patienst required reoperation. The hospital stay was one day for 19 patients (95%), while there was 1 patient (5%) who was discharged from hospital after three days due to abdominal colics of irritable bowel syndrome (IBS). In that period, no patient required ring removal or conversion to Roux-en-Y gastric bypass surgery. Food intolerance/ vomiting wasn’t present in any patient (0%), bile reflux was present in 2 patients (10%), 1 patient (5%) presented with alkaline reflux that was readmitted and underwent conservative treatment, and no stomal ulcers were observed. Mean % excess weight loss at 6 and 12 months was 55.72% and 77.36%, respectively. All patients with the reported preoperative comorbidities had a complete resolution of comorbidities. As regards postoperative nutritional deficiencies, we had no cases (0%) diagnosed with anemia, hypoalbuminemia, or iron deficiency. We had one patient (5%) with vitamin D deficiency, and another patient (5%) with hypocalcemia. Both of those patients were not completely compliant on the regular postoperative multivitamin supplements. Conclusion Laparoscopic banded One Anastomosis Gastric Bypass is a safe and efficacious procedure with excellent preliminary short-term results. Weight loss in the first year is durable, and dumping syndrome and bile reflux are limited. It also proved effective as regards comorbidities resolution such as DM, HTN and hyperlipidemia, and in case of complications, the ring can be easily removed laparoscopically.