Midterm outcomes of one anastomosis gastric bypass for patients with BMI < 35 kg/m2 from a large single center.

BACKGROUND: One-anastomosis gastric bypass (OAGB) is gaining more attention in patients with severe obesity and recently is used for patients with body mass index (BMI) < 35 kg/m2. In this 5-year single center experience we aim to report our outcomes of using OAGB for patients with BMI < 35 kg/m2. METHODS: This is a retrospective analysis of prospectively collected data recorded in to our national obesity registry database. Variables including age, sex, weight, BMI, any associated disease, blood levels of metabolic markers, nutrients, and vitamins before and after surgery were extracted and analyzed. RESULTS: 173 patients with mean age and BMI of 41 ± 10 years and 33 ± 1 kg/m2 underwent OAGB and at least one of the obesity-associated medical problems was found in 88 (50.5%) of them preoperatively. The mean duration of surgery and length of hospital stay were 60.7 ± 7.4 min and 1.3 ± 1.4 days. 78% and 70% of patients had available data at 24 and 60 months, respectively. The mean BMI was 23.9 ± 2.2 kg/m2 1 year after surgery and each year after that till 5 years was 24 ± 2, 24.4 ± 2.6, 25.1 ± 2.7, and 25.5 ± 2.7 kg/m2. Significant improvement in levels of fasting blood glucose, lipid profile, and liver enzymes were observed. CONCLUSION: OAGB for BMI < 35 kg/m2 has significant effects in weight loss, helps remit diabetes and hypertension in the majority of cases, improves lipid profile, and has no increased burden of postoperative problems or deficiency in nutritional factors rather than what is known and predictable.

Laparoscopic resection of gastric duplication cyst containing gastrointestinal stromal tumour: A case report.

Gastric duplication cyst (GDC) in adults is an extremely rare congenital anomaly. Here, we report the case of a GDC containing gastrointestinal stromal tumour (GIST) in a 60-year-old male patient who presented with abdominal pain. Laparoscopic resection with safe margins was performed following endosonographic localisation of the lesion. Pathologic evaluation revealed GDC containing GIST, and all surgical margins were free from tumours. The patient was discharged with good condition after 2 days and after 3 months of follow-up, the patient was symptom free and had no complications. Gastric duplication is a rare disease and may contain heterotopic tissue or even neoplastic lesions. Definite treatment is complete surgical removal that can be achieved laparoscopically with the aid of intraoperative ultrasonography for precise localisation of the indeterminate lesions.

One anastomosis gastric bypass as a one-stage bariatric surgical procedure in patients with BMI ≥ 50 kg/m2.

In patients with BMI ≥ 50 kg/m2, it is difficult to select an appropriate procedure that can lead to optimum results. This study aims to evaluate mid-term weight loss outcomes in patients with BMI ≥ 50 kg/m2 following one anastomosis gastric bypass (OAGB) as a one-stage procedure. A prospective study was conducted on patients with BMI ≥ 50 kg/m2, aged 18 years and above who had undergone primary OAGB from January 2016 to February 2019 with at least two years follow-ups. A total of 197 patients with BMI ≥ 50 kg/m2 had underwent OAGB. The mean age was 38 years and the mean pre-operative BMI was 53.7 kg/m2. Mean EWL% were 63.7%, 67.8% and 66.2% at one, two and five years after OAGB respectively. The highest level of EWL% was 68.4%, which was achieved in the 18th month following OAGB. OAGB can be performed safely in patients with BMI ≥ 50 kg/m2 as a one-stage procedure with acceptable weight loss outcomes and remission of obesity associated medical problems.

Phlegmon Formation due to Perforated Marginal Ulcer After One Anastomosis Gastric Bypass; Conversion to Roux-en-Y Gastric Bypass: a Video Case Report.

One anastomosis gastric bypass is now an accepted bariatric procedure in many countries. A rare but serious complication of OAGB is perforation of marginal ulcer with 0.5-1% incidence that needs urgent diagnosis and intervention. In cases of complicated or refractory ulcers, conversion to RYGB could be a definitive therapy.

Laparoscopic Roux-en-Y gastric bypass in intestinal non-rotation.

There are some incidental findings during bariatric surgery. Some of these findings may make the operation more challenging than routine surgery. Intestinal malrotation/non-rotation are rare congenital anomalies that may remain asymptomatic until bariatric surgery. Here we report a 30-year-old female patient with unknown intestinal congenital anomaly which was diagnosed during surgery and she underwent Roux-en-Y gastric bypass, which can be a challenging procedure in intestinal malrotation/non-rotation and conversion may be needed.