Department of Surgery, Fakhry & Dr. Ahmed Nasser Algarzaie Hospital, Khobar, Saudi Arabia.
Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Am J Case Rep. 2022 Aug 27;23:e936776. doi: 10.12659/AJCR.936776.
BACKGROUND Revisional bariatric surgeries to other restrictive or malabsorptive procedures are considered for inadequate weight reduction, weight regains, or complications. Literature on the application of reversion of one-anastomosis gastric bypass (OAGB) to normal anatomy is limited. We aimed to report our experiences with 5 OAGB reversion surgeries to normal anatomy that were conducted for different reasons. CASE REPORT Case 1: A 40-year-old woman underwent OAGB. She had peripheral neuropathy, lower limb edema, food intolerance, and biliary reflux. For those reasons, we performed revisional surgery. Case 2: A 30-year-old woman underwent OAGB. She had tiredness, dizziness, multiple fainting, and lower limb edema. Laboratory results showed hypoglycemia, mild hypoproteinemia, and proteinuria. Dietary instructions were unsuccessful. Therefore, we performed revisional surgery. Case 3: A 40-year-old woman underwent OAGB. She had reached a body mass index (BMI) of 19, which was not appreciated by her social contacts and caused her to experience depression. After a psychiatric assessment, she insisted on revisional surgery. Case 4: A 28-year-old woman underwent OAGB. Her BMI was 18, which was not accepted by her spouse, who criticized her body image. For that, we did revisional surgery. Case 5: A 52-year-old woman with hypothyroidism underwent OAGB. She had poor compliance with dietary instructions, complicated by liver failure, which was conservatively managed. She underwent revisional surgery after optimizing her condition. She was discharged in stable condition. CONCLUSIONS A multidisciplinary team should evaluate patients, and the decision to revise should come only after the failure of all conservative management methods.
对于减重效果不佳、体重反弹或出现并发症的患者，可考虑进行再次减重手术，如转为其他限制型或吸收不良型手术。有关将单吻合口胃旁路术（OAGB）转为正常解剖结构的应用文献有限。我们旨在报告因不同原因对 5 例 OAGB 转为正常解剖结构的手术经验。
病例 1：一名 40 岁女性接受了 OAGB 手术。她患有周围神经病变、下肢水肿、食物不耐受和胆汁反流。由于这些原因，我们进行了再次手术。
病例 2：一名 30 岁女性接受了 OAGB 手术。她感到疲倦、头晕、多次昏厥和下肢水肿。实验室检查结果显示低血糖、轻度低蛋白血症和蛋白尿。饮食指导无效。因此，我们进行了再次手术。
病例 3：一名 40 岁女性接受了 OAGB 手术。她的体重指数（BMI）达到了 19，这令她的社交圈不满意，并导致她感到抑郁。经过精神科评估后，她坚持要求进行再次手术。
病例 4：一名 28 岁女性接受了 OAGB 手术。她的 BMI 为 18，这令她的配偶不满意，其对她的体型提出了批评。因此，我们进行了再次手术。
病例 5：一名患有甲状腺功能减退症的 52 岁女性接受了 OAGB 手术。她对饮食指导的依从性差，合并肝功能衰竭，经保守治疗后情况稳定。在优化病情后，她接受了再次手术。她出院时情况稳定。
应通过多学科团队对患者进行评估，只有在所有保守治疗方法失败后，才能做出再次手术的决定。
