Revision/conversion surgeries after one anastomosis gastric bypass - an experts' modified Delphi consensus
Kermansaravi, Mohammad Chiappetta, Sonja Parmar, Chetan Carbajo, Miguel A Musella, Mario Chevallier, Jean-Marc Ribeiro, Rui Ramos, Almino C Weiner, Rudolf Nimeri, Abdelrahman
Kermansaravi, Mohammad
Chiappetta, Sonja
Parmar, Chetan
Carbajo, Miguel A
Musella, Mario
Chevallier, Jean-Marc
Ribeiro, Rui
Ramos, Almino C
Weiner, Rudolf
Nimeri, Abdelrahman
Abstract
Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.
Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus.
Results: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300-400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB.
Conclusion: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues.
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Date
2024-06-11
Type
Article
Subject
Surgery
Collections
Citation
Kermansaravi M, Chiappetta S, Parmar C, Carbajo MA, Musella M, Chevallier JM, Ribeiro R, Ramos AC, Weiner R, Nimeri A, Aarts E, Abbas SI, Bashir A, Behrens E, Billy H, Cohen RV, Caina D, De Luca M, Dillemans B, Fobi MAL, Neto MG, Gawdat K, ElFawal MH, Kasama K, Kassir R, Khan A, Kow L, Kular KDS, Lakdawala M, Layani L, Lee WJ, Luque-de-León E, Mahawar K, Almomani H, Miller K, González JCO, Prasad A, Rheinwalt K, Rutledge R, Safadi B, Salminen P, Shabbir A, Taskin HE, Verboonen JS, Vilallonga R, Wang C, Shikora SA, Prager G. Revision/Conversion Surgeries After One Anastomosis Gastric Bypass-An Experts' Modified Delphi Consensus. Obes Surg. 2024 Jul;34(7):2399-2410.
Journal / Source Title
Obesity Surgery
DOI
10.1007/s11695-024-07345-8
PMID
38862752
Publisher
Springer