Banded One Anastomosis Gastric Bypass: 15 Year Results from a Single Centre.

BACKGROUND

Banded one anastomosis gastric bypass (BOAGB) is an efficacious surgical option for patients with obesity. OAGB has a high percentage excess weight loss reported in the literature, and the addition of a silastic ring (SR) otherwise known as a band, helps to reduce recurrent weight gain.

METHODS

156 patients from a single centre between 2005-2008 underwent a BOAGB. A questionnaire, blood test results and electronic records were utilised at 15 years post-operatively to identify patient outcomes.

RESULTS

At 15 years, the average percentage excess weight loss (%EWL) was 82.0%, the average percentage total weight loss (%TWL) was 35.9%, and the average body mass index (BMI) had reduced from 46.3 kg/m to 29.7 kg/m. 106/114 (93.0%) of patients had adequate weight loss at 15 years. 27/114 (23.7%) of patients had recurrent weight gain at 15 years. Antihypertensives, lipid lowering therapy and hypoglycaemic medications had all reduced, and proton pump inhibitor medications had increased. There were 11 (7.1%) deaths by 15 years, and none were directly related to the initial operation. Silastic rings were removed in 12 patients (7.7%). 21 (13.5%) patients had a conversion to a Roux-en-Y gastric bypass over 15 years, of which 14 (9.0%) were due to reflux. There were no conversions for malnutrition. Patient satisfaction was high, with an average Likert satisfaction score of 8.4.

CONCLUSIONS

BOAGB continues to show good results as an effective operation at 15 years, with a high %EWL and %TWL, low conversion rate, and significant reduction in medication use for hypertension, hyperlipidaemia, and T2D. There was an increase in proton pump inhibitor use at 15 years. The operation is durable and weight loss remains excellent. The addition of a SR is effective in reducing long-term recurrent weight gain.