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Reversal to Normal Anatomy After One-Anastomosis/Mini Gastric Bypass, Indications and Results: A Systematic Review and Meta-Analysis Publisher Pubmed



Kermansaravi M1 ; Shahmiri SS2 ; Davarpanah Jazi AH3 ; Valizadeh R4 ; Weiner RA5 ; Chiappetta S6
Authors
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Authors Affiliations
  1. 1. Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Rasool-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran, Iran
  3. 3. Minimally Invasive Surgery Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Epidemiology, Student Research Committee, School of Public Health, Iran University of Medical science, Tehran, Iran
  5. 5. Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, Offenbach am Main, Germany
  6. 6. Obesity and Metabolic Surgery Unit, Department of General Surgery, Ospedale Evangelico Betania, Naples, Italy

Source: Surgery for Obesity and Related Diseases Published:2021


Abstract

This review evaluates the indications and outcomes of one-anastomosis/mini gastric bypass (OAGB/MGB) reversal to normal anatomy. A systematic literature search and meta-analysis was performed in PubMed, Web of Science, and Scopus for articles published by October 1, 2020, including the keywords “one anastomosis gastric bypass,” “OAGB,” “mini gastric bypass,” “MGB,” “reversal,” “reverse,” “malnutrition,” and “reversal bariatric surgery”. After examining 182 papers involving 11,578 patients, 14 studies were included. A reversal was performed in 119 patients on average 23.6 months after the primary OAGB/MGB surgery. The mean body mass index (BMI) was 22.92 ± 3.47 kg/m2 and the mean albumin level was 25.17 ± 4.21 g/L at reversal. The mean length of the common channel (CC) was 383.57 ± 159.35 cm, with a mean biliopancreatic limb (BPL) length of 214.21 ± 48.45 cm. Pooled estimation of the meta-analysis of prevalence studies reported a prevalence of 1% for reversal. The major signs and symptoms of protein-energy malnutrition were the leading causes of the reversal of OAGB/MGB. Bleeding, leakage, and death due to severe liver failure were the most reported complications after reversal, with an overall incidence of 10.9%. In conclusion, OAGB/MGB reversal has a prevalence of 1% and has a complication rate of 10.9%. Protein-energy malnutrition with hypoalbuminemia was the most common etiology. The mean lengths of BPL and CC were reported as 215 cm and 380 cm, respectively, in the cases. Therefore, special attention should be paid to malnutrition in all OAGB/MGB patients during follow-up to prevent severe malnutrition and subsequent increase in reversal procedures. © 2021 American Society for Bariatric Surgery
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