Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
Langenbecks Arch Surg. 2024 Aug 22;409(1):259. doi: 10.1007/s00423-024-03443-4.
Hypoalbuminemia following One-Anastomosis Gastric Bypass (OAGB) surgery remains a major concern among bariatric surgeons. This study aims to assess the outcome of partial reversal to normal anatomy with gastro-gastrostomy alone in patients with refractory hypoalbuminemia following OAGB surgery.
A retrospective study was performed on patients who underwent partial reversal surgery with gastro-gastrostomy alone due to refractory hypoalbuminemia post-OAGB surgery, using data from the Iran National Obesity Surgery Database, from 2013 to 2022.
Of 4640 individuals undergoing OAGB, 11 underwent gastro-gastrostomy due to refractory hypoalbuminemia. The median time from OAGB to partial reversal was 16.6 months and the BPL length ranged from 155 to 200 cm. The follow-up period ranged from 1 to 7 years. The mean BMI was 27.3 (7.5) kg/m² before partial reversal. The mean BMI post-reversal was 30.9 (4.2) kg/m² after 1 year and 33.3 (3.8) kg/m² after 2 years. Serum albumin levels significantly increased from 3.0 (0.4) g/dL to 4.0 (0.5) g/dL following gastro-gastrostomy (p-value < 0.001). Serum liver enzymes (SGOT, SGPT, ALP) significantly decreased post-gastro-gastrostomy (p-value < 0.05). Nine individuals (81.8%) achieved resolution of hypoalbuminemia after gastro-gastrostomy with maintenance of ≥ 20% TWL and ≥ 50% EWL. No cases of anastomotic stricture, leak, bleeding, or major complications were reported after gastro-gastrostomy.
Gastro-gastrostomy appears to be a safe and efficacious technique for addressing refractory hypoalbuminemia following OAGB. The procedure preserves the weight loss achieved following OAGB without significant complications. However, further studies are required to validate these findings.
One-Anastomosis Gastric Bypass（OAGB）手术后低白蛋白血症仍然是肥胖症外科医生关注的主要问题。本研究旨在评估在 OAGB 手术后因低白蛋白血症而进行胃-胃吻合术的部分逆转对难治性低白蛋白血症患者的结局。
回顾性分析 2013 年至 2022 年伊朗国家肥胖症手术数据库中因 OAGB 手术后难治性低白蛋白血症而行胃-胃吻合术部分逆转手术的患者资料。
在 4640 例行 OAGB 的患者中，有 11 例因难治性低白蛋白血症而行胃-胃吻合术。从 OAGB 到部分逆转的中位时间为 16.6 个月，BPL 长度为 155-200cm。随访时间为 1-7 年。部分逆转前平均 BMI 为 27.3（7.5）kg/m²。逆转后 1 年平均 BMI 为 30.9（4.2）kg/m²，2 年时为 33.3（3.8）kg/m²。胃-胃吻合术后血清白蛋白水平从 3.0（0.4）g/dL 显著升高至 4.0（0.5）g/dL（p 值<0.001）。胃-胃吻合术后血清肝酶（SGOT、SGPT、ALP）显著降低（p 值<0.05）。9 例（81.8%）患者在胃-胃吻合术后实现低白蛋白血症缓解，同时保持≥20%的 TWL 和≥50%的 EWL。胃-胃吻合术后无吻合口狭窄、漏、出血或重大并发症发生。
胃-胃吻合术似乎是一种安全有效的治疗 OAGB 后难治性低白蛋白血症的方法。该术式保留了 OAGB 术后的减重效果，且无明显并发症。然而，还需要进一步的研究来验证这些发现。
