Conversion of One-Anastomosis Gastric Bypass to Roux-en-Y Gastric Bypass: Short Term Results from a Tertiary Referral Center

Abstract Background One-anastomosis gastric bypass (OAGB), also known as mini gastric bypass, is an increasingly popular bariatric surgery option worldwide. While OAGB offers advantage in terms of procedure time and technical ease, revisional operations to correct complications may be necessary. Objectives We aimed to describe the indications and perioperative outcomes for OAGB conversions to Roux-en-Y gastric bypass (RYGB) at a single referral center. Setting Academic Hospital, Abu Dhabi, United Arab Emirates Methods All Patients undergoing conversion from OAGB to RYGB from February 2016 through September 2018 were retrospectively identified from a prospectively-maintained database of revisional bariatric surgeries. Results Sixteen patients underwent conversion from previous OAGB to RYGB during the study period. The cohort was 62.5% female (n=10) with a mean age of 40.2 years and median BMI of 30.7 kg/m2. Indications for conversion included intractable nausea/vomiting (n=8, 50.0%), biliary reflux (n=3, 18.8%), weight recidivism (n=3, 18.8%), and protein-calorie malnutrition (n=2, 12.5%). Twelve cases (75.0%) were successfully completed with a laparoscopic approach, with four cases (25.0%) converted to open. The median length of stay was 5.5 days. Six patients (37.5%) experienced minor and major complications within 30 days of discharge. Fourteen patients (87.5%) were available for follow-up at six months, with one-hundred percent of these patients reporting resolution of their pre-operative symptoms. There were no mortalities. Conclusions Data from this largest reported single-center experience demonstrates that conversion of OAGB to RYGB is safe and technically feasible. Further studies and longer-term follow-up are needed to definitively describe outcomes following this revisional bariatric surgery.