IBC Oxford University Oral Abstract 19 - Video abstract: disaster in MGB-OAGB—lessons learned

Abstract Introduction While One Anastomosis Gastric Bypass (OAGB) has proven to be an effective surgical treatment for obesity, a significant number of patients experience excessive weight loss, leading to malnutrition and related complications. Rapid and excessive weight loss can result in protein-energy malnutrition, vitamin and mineral deficiencies, and dehydration, which can have severe consequences on overall health and quality of life. Case Presentation We present a case of management of a patient who had severe weight loss and its consequences after OAGB. He is a 55-year-old male who presented with the complaint of severe retrosternal burning, pain, nausea and increased frequency of stools. He gave a history of more than 70 kg weight loss 6 months after OAGB done at another institution. On careful evaluation he had severe malnutrition indicated by severe hypoproteinaemia and hypoalbuminemia. After careful discussion with the patient, we decided to do a diagnostic laparoscopy with a plan to reverse the OAGB and normalise the anatomy by gastro-gastric anastomosis. Intraoperative findings showed a biliopancreatic limb length of 400 cm and common channel length of just 100 cm. Moreover, the gastrojejunostomy was done in an anti-peristaltic manner. We reversed the gastrojejunostomy and did a gastro-gastric anastomosis. The operation was uneventful, and the patient recovered well. Conclusion OAGB is a safe procedure in expert hands. This case shows the difficulty of surgery done by inexperienced surgeons but was managed by bypass reversal.