Optimal Bilio-Pancreatic Limb (BPL) Length in One Anastomosis Gastric Bypass (OAGB) Surgery

Buchwald H. The evolution of metabolic/bariatric surgery. Obes Surg. 2014;24(8):1126–1135. https://doi.org/10.1007/S11695-014-1354-3

Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47(6):1345–51. https://doi.org/10.1016/S0039-6109(16)38384-0.

Article  CAS  PubMed  Google Scholar 

Mason EE, Ito C. Gastric bypass. Ann Surg. 1969;170(3):329. https://doi.org/10.1097/00000658-196909010-00003.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Griffen WO, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg. 1977;186(4):500–9. https://doi.org/10.1097/00000658-197710000-00012.

Article  PubMed  PubMed Central  Google Scholar 

Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4(4):353–7. https://doi.org/10.1381/096089294765558331.

Article  CAS  PubMed  Google Scholar 

Sinclair P, Brennan DJ, le Roux CW. Gut adaptation after metabolic surgery and its influences on the brain, liver and cancer. Nat Rev Gastroenterol Hepatol. 2018 Oct;15(10):606–624. https://doi.org/10.1038/S41575-018-0057-Y

Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276–80. https://doi.org/10.1381/096089201321336584.

Article  CAS  PubMed  Google Scholar 

Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005 Oct;15(9):1304–1308. https://doi.org/10.1381/096089205774512663

Lee WJ, Ser KH, Lee YC, Tsou JJ, Chen SC, Chen JC. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012 Dec;22(12):1827–1834. https://doi.org/10.1007/S11695-012-0726-9

Jammu GS, Sharma R. A 7-Year clinical audit of 1107 cases comparing sleeve gastrectomy, Roux-En-Y gastric bypass, and mini-gastric bypass, to Determine an Effective and Safe Bariatric and Metabolic Procedure. Obes Surg. 2016 May;26(5):926–32. https://doi.org/10.1007/S11695-015-1869-2.

Robert M et al. Efficacy and safety of one anastomosis gastric bypass versus Roux-en-Y gastric bypass for obesity (YOMEGA): a multicentre, randomised, open-label, non-inferiority trial. The Lancet. 2019 Mar;393(10178):1299–1309. https://doi.org/10.1016/S0140-6736(19)30475-1

Liagre A et al. Ten-year outcome of one-anastomosis gastric bypass with a biliopancreatic limb of 150 cm versus Roux-en-Y gastric bypass: a single-institution series of 940 patients. Surg Obes Relat Dis. 2022 Oct;18(10):1228–1238. https://doi.org/10.1016/j.soard.2022.05.021

Parmar CD, Mahawar KK. One anastomosis (Mini) gastric bypass is now an established bariatric procedure: a systematic review of 12,807 patients. Obes Surg. 2018 Sep;28(9):2956–67. https://doi.org/10.1007/S11695-018-3382-X.

Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK. ‘Mini’ gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013 Nov;23(11):1890–1898. https://doi.org/10.1007/S11695-013-1026-8

Ramos AC et al. IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): Results of a Modified Delphi Study. Obes Surg. 2020 May;30(5):1625–1634. https://doi.org/10.1007/S11695-020-04519-Y

Mahawar KK et al. The first consensus statement on one anastomosis/mini gastric bypass (OAGB/MGB) using a modified delphi approach. Obes Surg. 2017 Dec;28(2):303–312. https://doi.org/10.1007/S11695-017-3070-2

De Luca M, et al. Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg. 2018 May;28(5):1188–206. https://doi.org/10.1007/S11695-018-3182-3.

De Luca M, et al. IFSO update position Statement on one anastomosis gastric bypass (OAGB). Obes Surg. 2021 Jul;31(7):3251–78. https://doi.org/10.1007/S11695-021-05413-X.

American Society for Metabolic and Bariatric Surgery. ASMBS Endorsed Procedures and FDA Approved Devices: Accessed: Oct. 03, 2024. [Online]. Available: https://asmbs.org/resources/endorsed-procedures-and-devices/

Rheinwalt KP, Plamper A, Rückbeil MV, Kroh A, Neumann UP, Ulmer TF. One anastomosis gastric bypass-mini-gastric bypass (OAGB-MGB) versus Roux-en-Y gastric bypass (RYGB)-a mid-term cohort study with 612 patients. Obes Surg. 2020 Apr;30(4):1230–1240. https://doi.org/10.1007/S11695-019-04250-3

Mustafa A, Rizkallah NNH, Samuel N, Balupuri S. Laparoscopic Roux-En-Y gastric bypass versus one anastomosis (loop) gastric bypass for obesity: A prospective comparative study of weight loss and complications. Annals of Medicine and Surgery. 2020 Jul;55:143. https://doi.org/10.1016/J.AMSU.2020.04.040

Bruder SJ, Freeman JB, Brazeau-Gravelle P. Lengthening the Roux-Y Limb increases weight loss after gastric bypass: a preliminary report. Obes Surg. 1991;1(1):73–7. https://doi.org/10.1381/096089291765561501.

Article  CAS  PubMed  Google Scholar 

Mahawar KK, Sharples AJ. Contribution of malabsorption to weight loss after Roux-en-Y gastric bypass: a systematic review. Obes Surg. 2017 Aug;27(8):2194–2206. https://doi.org/10.1007/S11695-017-2762-Y

Mahawar KK, et al. Small bowel Limb lengths and Roux-en-Y gastric bypass: a systematic review. Obes Surg. 2016 Mar;26(3):660–71. https://doi.org/10.1007/S11695-016-2050-2.

Madan AK, Harper JL, Tichansky DS. Techniques of laparoscopic gastric bypass: on-line survey of American Society for Bariatric Surgery practicing surgeons. Surg Obes Relat Dis. 2008 Mar;4(2):166–172. https://doi.org/10.1016/J.SOARD.2007.08.006

Kumar P, Yau HCV, Trivedi A, Yong D, Mahawar K. Global variations in practices concerning Roux-en-Y Gastric bypass-an online survey of 651 bariatric and metabolic surgeons with cumulative experience of 158,335 procedures. Obes Surg. 2020 Nov;30(11):4339–4351. https://doi.org/10.1007/S11695-020-04796-7

Nergaard BJ, Leifsson BG, Hedenbro J, Gislason H. Gastric bypass with long alimentary limb or long pancreato-biliary limb–long-term results on weight loss, resolution of co-morbidities and metabolic parameters. Obes Surg. 2014 Oct;24(10):1595–1602. https://doi.org/10.1007/S11695-014-1245-7

Kumar P, Yau HCV, Trivedi A, Yong D, Mahawar K. Global variations in practices concerning Roux-en-Y gastric bypass—an online survey of 651 bariatric and metabolic surgeons with cumulative experience of 158,335 procedures. Obes Surg. 2020 Nov;30(11):4339–4351. https://doi.org/10.1007/S11695-020-04796-7/TABLES/11

Mahawar KK, et al. Perioperative practices concerning one anastomosis (Mini) gastric bypass: a survey of 210 surgeons. Obes Surg. 2018 Jan;28(1):204–11. https://doi.org/10.1007/S11695-017-2831-2.

Mahawar KK. Another fatal outcome with a biliopancreatic limb length of 200 cm with one anastomosis gastric bypass. Obes Surg. 2017 Jul;27(7):1882–3. https://doi.org/10.1007/S11695-017-2695-5.

Mahawar KK. Liver dysfunction with both Roux-en-Y and one-anastomosis gastric bypass is almost exclusively seen with longer Than Standard Limb Lengths. Obes Surg. 2018 Feb;28(2):548–9. https://doi.org/10.1007/S11695-017-3028-4.

Mahawar KK. Yet another mortality with a biliopancreatic limb of > 200 cm with one anastomosis gastric bypass. Obes Surg. 2018 Nov;28(11):3634–3635. https://doi.org/10.1007/S11695-018-3462-Y

Lee WJ, Yu PJ, Wang W, Chen TC, Wei PL, Huang MT. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005 Jul;242(1):20–28. https://doi.org/10.1097/01.SLA.0000167762.46568.98

Musella M, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28(1):156–63. https://doi.org/10.1007/S00464-013-3141-Y.

Article  CAS  PubMed  Google Scholar 

Taha O, Abdelaal M, Abozeid M, Askalany A, Alaa M. Outcomes of omega loop gastric bypass, 6-Years experience of 1520 cases. Obes Surg. 2017 Aug;27(8):1952–60. https://doi.org/10.1007/S11695-017-2623-8.

Lee WJ, Wang W, Lee YC, Te Huang M, Ser KH, Chen JC. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008 Mar;18(3):294–299. https://doi.org/10.1007/S11695-007-9367-9

Ahuja A, et al. MGB-OAGB: effect of biliopancreatic limb length on nutritional deficiency, weight loss, and comorbidity resolution. Obes Surg. 2018 Nov;28(11):3439–45. https://doi.org/10.1007/S11695-018-3405-7.

Noun R, Skaff J, Riachi E, Daher R, Antoun NA, Nasr M. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012 May;22(5):697–703. https://doi.org/10.1007/S11695-012-0618-Z.

Hussain A, EL-Hasani S. Short- and mid-term outcomes of 527 one anastomosis gastric Bypass/mini-gastric bypass (OAGB/MGB) operations: retrospective study. Obes Surg. 2019 Jan;29(1):262–7. https://doi.org/10.1007/S11695-018-3516-1/METRICS.

Charalampos T, et al. Tailored one anastomosis gastric bypass: 3-Year outcomes of 94 patients. Obes Surg. 2019 Feb;29(2):542–51. https://doi.org/10.1007/S11695-018-3572-6/METRICS.

Jedamzik J, et al. Impact of limb length on nutritional status in one-anastomosis gastric bypass: 3-year results. Surg Obes Relat Dis. 2020 Apr;16(4):476–84. https://doi.org/10.1016/J.SOARD.2019.12.012.

Slagter N, et al. Outcomes of the one anastomosis gastric bypass with various biliopancreatic limb lengths: a retrospective single-center cohort study. Obes Surg. 2021 Oct;31(10):4236. https://doi.org/10.1007/S11695-021-05555-Y.

Kermansaravi M, Pishgahroudsari M, Kabir A, Abdolhosseini M, Pazouki A. Weight loss after one-anastomosis/mini-gastric bypass– the impact of biliopancreatic limb: a retrospective cohort study. J Res Med Sci. 2020 Jan;25(1). https://doi.org/10.4103/JRMS.JRMS_117_19.

Jain M, et al. Tailored one anastomosis gastric bypass– subgroup analysis of a randomised control trial based on bilio-pancreatic limb length with long-term results of 101 patients. J Minim Access Surg. 2022 Apr;18(2):264. https://doi.org/10.4103/JMAS.JMAS_117_21.

Gricks B, Eldredge T, Bessell J, Shenfine J. Outcomes of 325 one anastomosis gastric bypass operations: an Australian case series. ANZ J Surg. 2022 Sep;92(9):2123–2128. https://doi.org/10.1111/ANS.17702

Carbajo MA, Luque-de-León E, Jiménez JM, Ortiz-de-Solórzano J, Pérez-Miranda M, Castro-Alija MJ. Laparoscopic one-anastomosis gastric bypass: technique, results, and Long-Term Follow-Up in 1200 patients. Obes Surg. 2017 May;27(5):1153–67. https://doi.org/10.1007/S11695-016-2428-1.

Komaei I et al. One anastomosis gastric bypass–mini gastric bypass with tailored biliopancreatic limb length formula relative to small bowel length: preliminary results. Obes Surg. 2019 Sep;29(9):3062–3070. https://doi.org/10.1007/S11695-019-04019-8/METRICS

Ruiz-Mar G, Ruelas-Ayala A, Ornelas-Oñate LA, Ramirez-Velasquez JE. The one anastomosis gastric bypass technique: results after one year of follow-up. Arq Bras Cir Dig. 2019;32(4). https://doi.org/10.1590/0102-672020190001E1476.

Ruiz-Tovar J, Carbajo MA, Jimenez JM, Luque-de-Leon E, Ortiz-de-Solorzano J, Castro MJ. Are there ideal small bowel limb lengths for one-anastomosis gastric bypass (OAGB) to obtain optimal weight loss and remission of comorbidities with minimal nutritional deficiencies? World J Surg. 2020 Mar;44(3):855–862. https://doi.org/10.1007/S00268-019-05243-0

Zaki KMF, Moustafa AAS, Shafik YS, Helmy MM. Comparative study between total bowel measurement and proximal bowel measurement in laparoscopic one-anastomosis gastric bypass regarding effect on weight loss and nutritional status. The Egyptian Journal of Surgery. 2022 Oct;41(1):105–119. https://doi.org/10.4103/EJS.EJS_283_21

De Luca M, et al. A New Concept in bariatric surgery. Single anastomosis gastro-ileal (SAGI): technical details and preliminary results. Obes Surg. 2017 Jan;27(1):143–7. https://doi.org/10.1007/S11695-016-2293-Y.

Abdallah E, et al. One-anastomosis gastric bypass (OAGB) with fixed bypass of the proximal two meters versus tailored bypass of the proximal one-third of small bowel: short-term outcomes. Surg Endosc. 2022 Jan;36(1):328–35. https://doi.org/10.1007/S00464-020-08284-Y/METRICS.

Tacchino RM. Bowel length: measurement, predictors, and impact on bariatric and metabolic surgery. Surg Obes Relat Dis. 2015 Mar;11(2):328–34. https://doi.org/10.1016/J.SOARD.2014.09.016.

Teitelbaum EN, Vaziri K, Zettervall S, Amdur RL, Orkin BA. Intraoperative small bowel length measurements and analysis of demographic predictors of increased length. Clin Anat. 2013 Oct;26(7):827–832. https://doi.org/10.1002/CA.22238

Isreb S, Hildreth A, Mahawar K, Balupuri S, Small P. Laparoscopic instruments marking improve length Measurement Precision. World J Laparosc Surg. 2012 Apr;2(3):57–60. https://doi.org/10.5005/JP-JOURNALS-10007-1038.

Mahawar KK, Parmar C, Carr WRJ, Jennings N, Schroeder N, Small PK. Impact of biliopancreatic limb length on severe protein–calorie malnutrition requiring revisional surgery after one anastomosis (mini) gastric bypass. J Minim Access Surg. 2018 Jan;14(1):37. https://doi.org/10.4103/JMAS.JMAS_198_16.

Neuberg M, Blanchet MC, Gignoux B, Frering V. Long-term outcomes after one-anastomosis gastric bypass (OAGB) in morbidly obese patients. Obes Surg. 2020 Apr;30(4):1379–84. https://doi.org/10.1007/S11695-019-04287-4/METRICS.

Boyle M, Mahawar K. One anastomosis gastric bypass performed with a 150-cm biliopancreatic limb delivers weight loss outcomes similar to those with a 200-cm biliopancreatic limb at 18–24 months. Obes Surg. 2020 Apr;30(4):1258–1264. https://doi.org/10.1007/S11695-019-04359-5

Khalaj A et al. Comparing the efficacy and safety of Roux-en-Y gastric bypass with one-anastomosis gastric bypass with a biliopancreatic limb of 200 or 160 cm: 1-year results of the Tehran Obesity Treatment Study (TOTS). Obes Surg. 2020 Sep;30(9):3528–3535. https://doi.org/10.1007/S11695-020-04681-3

Pizza F, et al. Biliopancreatic limb length in one anastomosis gastric bypass: which is the best? Obes Surg. 2020 Oct;30(10):3685–94. https://doi.org/10.1007/S11695-020-04687-X.

Omar I, Sam MA, Pegler ME, Pearson EJB, Boyle M, Mahawar K. Effect of one anastomosis gastric bypass on haematinics, vitamin D and parathyroid hormone levels: a comparison between 150 and 200 cm bilio-pancreatic limbs. Obes Surg. 2021 Jul;31(7):2954–2961. https://doi.org/10.1007/S11695-021-05281-5

Liagre A et al. One anastomosis gastric bypass with a biliopancreatic limb of 150 cm: weight loss, nutritional outcomes, endoscopic results, and quality of life at 8-year follow-up. Obes Surg. 2020 Nov;30(11):4206–4217. https://doi.org/10.1007/S11695-020-04775-Y

Mahawar KK. A Biliopancreatic Limb of > 150 cm with OAGB/MGB Is Ill-Advised. Obes Surg. 2017 Aug;27(8):2164–5. https://doi.org/10.1007/S11695-017-2736-0.

Osman Abouzeid TA, Ain Shoka AA, Abd elsamee KS, Atia. From diabetes remedy to diabetes remission; could single-anastomosis gastric bypass be a safe bridge to reach target in non-obese patients? Asian J Surg. 2019 Jan;42(1):307–313. https://doi.org/10.1016/J.ASJSUR.2018.04.002

Lee WJ, Chong K, Lin YH, Wei JH, Chen SC. Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for the treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect. Obes Surg. 2014;24(9):1552–62. https://doi.org/10.1007/S11695-014-1344-5.

Article  PubMed  Google Scholar 

Garciacaballero M, et al. Improvement of C peptide zero BMI 24–34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA). Nutr Hosp. 2013;28:35–46. https://doi.org/10.3305/NH.2013.28.SUP2.6712. Suppl 2, no. SUPPL2.

Article  CAS  PubMed  Google Scholar 

Lee WJ, Wang W, Lee YC, Te Huang M, Ser KH, Chen JC. Effect of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: comparison of BMI > 35 and < 35 kg/m2. J Gastrointest Surg. 2008 May;12(5):945–52. https://doi.org/10.1007/S11605-007-0319-4.

García-Caballero M, et al. Resolution of diabetes mellitus and metabolic syndrome in normal weight 24–29 BMI patients with one anastomosis gastric bypass. Nutr Hosp. 2012;27(2):623–31. https://doi.org/10.1590/S0212-16112012000200041.

Article  PubMed  Google Scholar 

Evdoshenko VV, Fedenko VV, Bordan NS, Matveev NL, Tsepkovsky AS. One-anastomosis gastric bypass with a short limb. Khirurgiia (Sofiia). 2020;1137–45. https://doi.org/10.17116/HIRURGIA202011137.

Mahawar K. We should now study bilio-pancreatic limb of 100 cm with one anastomosis gastric bypass. Obes Surg. 2021 Feb;31(2):877–8. https://doi.org/10.1007/S11695-020-04952-Z.

Comments (0)

No login
gif