Poghosyan Tigran, Alameh Ali, Bruzzi Matthieu, Faul Adrien, Rives-Lange Claire, Zinzindohoue Franck, Douard Richard, Chevallier Jean-Marc
Department of Digestive, Oncologic and Bariatric Surgery, AP-HP, Hôpital Européen Georges Pompidou and Université Paris Descartes, 20 Rue Leblanc, 75015, Paris, France.
Department of nutrition, AP-HP, Hôpital Européen Georges Pompidou and Université Paris Descartes, Paris, France.
Obes Surg. 2019 Aug;29(8):2436-2441. doi: 10.1007/s11695-019-03864-x.
One anastomosis gastric bypass (OAGB) was suggested as an option in the management of weight loss failure after sleeve gastrectomy (SG). In parallel, the length of the biliopancreatic limb (BPL) is currently debated.
To evaluate morbidity and efficiency of the conversion of SG to OAGB using two lengths of BPL (150 cm versus 200 cm).
Retrospective analysis of a prospectively collected database on 72 patients operated on between 2007 and 2017: (200-cm BPL before 2014 versus 150-cm BPL since 2014).
At revision, the mean body mass index (BMI) was 43.6 ± 7 kg/m. Sixteen patients (20%) had type 2 diabetes (T2D) and 23 (29%) had obstructive sleep apnea (OSA). Early morbidity rate was 4.2% (n = 3). Mean BMI were 33.7 ± 6 and 34.8 ± 9 at 2 and 5 years, respectively. At 5 years, the rate of lost of follow-up was 34%. T2D and OSA improved in 80% (n = 12) and 70% (n = 16) of the patients, respectively. At revision, the mean BMI were 46 ± 8 kg/m and 41 ± 6 kg/m for patients with 200-cm BPL (n = 38) and 150-cm BPL (n = 34), respectively. Two years after conversion, the mean BMI were 34 ± 1 kg/m for 200-cm BPL and 32 ± 7 kg/m for 150-cm BPL. The rate of gastroesophageal reflux disease (GERD) and diarrhea was 13% and 5% in patients with 200-cm BPL versus 3% and 0% in patients with 150-cm BPL.
This study shows that the conversion of SG to OAGB is feasible and safe allowing significant weight loss and improvement in comorbidities. Weight loss seems comparable between the 150-cm and 200-cm BPL.
单吻合口胃旁路术（OAGB）被提议作为袖状胃切除术（SG）后减重失败管理的一种选择。与此同时，胆胰支（BPL）的长度目前存在争议。
评估采用两种长度的BPL（150厘米与200厘米）将SG转换为OAGB的发病率和有效性。
对2007年至2017年间接受手术的72例患者的前瞻性收集数据库进行回顾性分析：（2014年之前为200厘米的BPL，2014年之后为150厘米的BPL）。
翻修时，平均体重指数（BMI）为43.6±7千克/平方米。16例患者（20%）患有2型糖尿病（T2D），23例（29%）患有阻塞性睡眠呼吸暂停（OSA）。早期发病率为4.2%（n = 3）。2年和5年时的平均BMI分别为33.7±6和34.8±9。5年时，失访率为34%。T2D和OSA分别在80%（n = 12）和
