The IFSO Worldwide One Anastomosis Gastric Bypass Survey: Techniques and Outcomes?
Por:
Haddad, Ashraf, Bashir, Ahmad, Fobi, Mathias, Higa, Kelvin, Herrera, Miguel F., Torres, Antonio J., Himpens, Jacques, Shikora, Scott, Ramos, Almino Cardoso, Kow, Lilian, Nimeri, Abdelrahman Ali
Publicada:
1 abr 2021
Resumen:
Introduction One anastomosis gastric bypass (OAGB) has become one of the
most commonly performed gastric bypass procedures in some countries.
Objectives To assess how surgeons viewed the OAGB, perceptions,
indications, techniques, and outcomes, as well as the incidence of
short- and long-term complications and how they were managed worldwide.
Methods A questionnaire was sent to all IFSO members in all 5 chapters
to study the pattern of practice and outcomes of OAGB. Results Seven
hundred and forty-two surgeons responded. The most commonly performed
procedures were sleeve gastrectomy (SG), Roux-en-Y gastric bypass
(RYGB), and OAGB. Preoperatively, 70% of the surgeons performed
endoscopy routinely. In regards to weight loss, 83% (570 surgeons)
responded that OAGB produces better weight loss than SG, and 49% (342
surgeons) responded that OAGB produces better weight loss than RYGB. The
most common length of the biliopancreatic limb (BPL) utilized was 200
cm. Sixty-seven percent of surgeons did not measure the total length of
the small bowel. In patients with reflux disease and history of smoking,
53% and 22% of surgeons respectively still offered OAGB as a treatment
option. Postoperatively, leak was documented in 963 patients, and it was
the leading cause for mortality. Leak management was conservative in
35%. Conversion to RYGB was performed in 31%. In 16% the anastomosis
was reinforced, 6% of the patients were reversed, and other procedures
were performed in 12%. Revision of OAGB for malnutrition/steatorrhea or
severe bile reflux was reported at least once by 37% and 45% of
surgeons, respectively (200 cm was the most commonly encountered
biliopancreatic limb BPL in those revised for malnutrition). Most common
strategy for revision was conversion to RYGB (43%), reversal to normal
anatomy (32%), shortening of the BPL (20%), and conversion to SG
(5%). Nevertheless, 5 out of 98 mortalities (5%) were due to liver
failure/malnutrition. Conclusion There are infrequent but potentially
severe specific complications including malnutrition, liver failure, and
bile reflux that may require surgical correction after OAGB.
Filiaciones:
Haddad, Ashraf:
Jordan Hosp, Gastrointestinal Bariatr & Metab Ctr, Minimally Invas & Bariatr Surg, Queen Noor St,4th Circle,POB 3073, Amman 11181, Jordan
Bashir, Ahmad:
Jordan Hosp, Gastrointestinal Bariatr & Metab Ctr, Minimally Invas & Bariatr Surg, Queen Noor St,4th Circle,POB 3073, Amman 11181, Jordan
Fobi, Mathias:
Mohak Bariatr & Robot, Clin Affairs & Res, Indore, India
Higa, Kelvin:
Calif State Univ Fresno, Adv Laparoscop Surg Associates, Fresno Heart & Surg Hosp, Fresno, CA 93740 USA
Herrera, Miguel F.:
Univ Nacl Autonoma Mexico, INCMNSZ, Endocrine & Bariatr Surg, Mexico City, DF, Mexico
Torres, Antonio J.:
Univ Complutense Madrid, Gen & Bariatr Surg, Hosp Clin San Carlos, Madrid, Spain
Himpens, Jacques:
CHIREC Delta Hosp, Metab Bariatr Surg, Brussels, Belgium
St Pierre Univ Hosp, Brussels, Belgium
Shikora, Scott:
Harvard Med Sch, Ctr Metab & Bariatr Surg, Brigham & Womens Hosp, Boston, MA 02115 USA
Ramos, Almino Cardoso:
Inst Metab Optimizat, Gastroobeso Ctr, Sao Paulo, SP, Brazil
Kow, Lilian:
Adelaide Bariatr Ctr, 12 Parade, Norwood, SA 5067, Australia
Nimeri, Abdelrahman Ali:
Carolinas Med Ctr, Atrium Hlth Weight Management, Charlotte, NC 28203 USA
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