Tse Andrew, Li Simeng, Ferguson Jorgen, Kyang Lee, Lord Reginald
The University of New South Wales, Sydney, Australia.
St Vincent's Hospital Sydney, Darlinghurst, Australia.
Obes Surg. 2025 Sep 9. doi: 10.1007/s11695-025-08219-3.
One-anastomosis gastric bypass (OAGB) has gained popularity as a bariatric operation due to its shorter operation time and lower perioperative complication rates, compared with Roux-en-Y gastric bypass (RYGB). However, OAGB is associated with short and long-term complications. Notably, in some reports a subset of patients developed liver dysfunction after OAGB, in some cases causing death or requiring liver transplantation.
A systematic review and meta-analysis were conducted following PRISMA guidelines. MEDLINE, EMBASE and PubMed databases were searched for studies published from 1946 to June 2024, focusing on the prevalence of liver dysfunction post-OAGB. Data extraction and quality assessment were performed by two independent reviewers. Statistical analysis includes pooled prevalence estimates, subgroup analysis against biliopancreatic limb length and regions of the included studies, sensitivity analysis and public bias assessment by Egger's test.
Of the 3223 identified articles, 7 studies met the inclusion criteria, involving 2944 patients, with 91 patients developing liver dysfunction post-OAGB. The pooled prevalence of liver dysfunction was 1.2% (95% CI 0.3-2.1%), with significant heterogeneity (I = 88.5%, p < 0.001). Subgroup analyses did not identify contributors to the heterogeneity. Sensitivity analysis validated the robustness of the findings, and no publication bias was detected by the Egger's test.
The prevalence of liver dysfunction post OAGB is low but clinically significant, warranting intense postoperative care and regular liver function monitoring. The lack of extensive data on this topic is a limitation, but as the first study to summarise current evidence, this study provides a foundation for future research.
与 Roux-en-Y 胃旁路术（RYGB）相比，单吻合口胃旁路术（OAGB）因其手术时间短和围手术期并发症发生率低，已成为一种流行的减肥手术。然而，OAGB 与短期和长期并发症相关。值得注意的是，一些报告显示，部分患者在接受 OAGB 后出现肝功能障碍，在某些情况下导致死亡或需要肝移植。
按照 PRISMA 指南进行系统评价和荟萃分析。检索 MEDLINE、EMBASE 和 PubMed 数据库中 1946 年至 2024 年 6 月发表的研究，重点关注 OAGB 术后肝功能障碍的患病率。由两名独立的审阅者进行数据提取和质量评估。统计分析包括合并患病率估计、根据纳入研究的胆胰肢长度和地区进行亚组分析、敏感性分析以及通过 Egger 检验进行发表偏倚评估。
在 3223 篇已识别的文章中，7 项研究符合纳入标准，涉及 2944 例患者，其中 91 例患者在 OAGB 术后出现肝功能障碍。肝功能障碍的合并患病率为 1.2%（95%CI 0.3 - 2.1%），存在显著异质性（I = 88.5% , p < 0.001）。亚组分析未发现导致异质性的因素。敏感性分析验证了研究结果的稳健性，Egger 检验未检测到发表偏倚。
OAGB 术后肝功能障碍的患病率较低，但具有临床意义，需要加强术后护理并定期监测肝功能。关于这一主题缺乏广泛的数据是一个局限性，但作为第一项总结当前证据的研究，本研究为未来的研究奠定了基础。
