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; Aarts, Edo; Abbas, Syed Imran; Bashir, Ahmad; Behrens, Estuardo; Billy, Helmuth; Cohen, Ricardo V; Caina, Daniel; De Luca, Maurizio; Dillemans, Bruno; Fobi, Mathias A L; Neto, Manoel Galvao; Gawdat, Khaled; ElFawal, Mohamad Hayssam; Kasama, Kazunori; Kassir, Radwan; Khan, Amir; Kow, Lilian; Kular, Kul Deepak Singh; Lakdawala, Muffazal; Layani, Laurent; Lee, Wei-Jei; Luque-de-León, Enrique; Mahawar, Kamal; Almomani, Hazem; Miller, Karl; González, Juan Carlos Olivares; Prasad, Arun; Rheinwalt, Karl; Rutledge, Robert; Safadi, Bassem; Salminen, Paulina; Shabbir, Asim; Taskin, Halit Eren; Verboonen, Jose Sergio; Vilallonga, Ramon; Wang, Cunchuan; Shikora, Scott A; Prager, Gerhard

Affiliation

Iran University of Medical Sciences; Naples Bariatric and Metabolic Surgery Unit; Whittington Hospital; Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Spain; Federico II" University; Université Paris 5; Hospital Lusíadas Amadora e Lisboa; Institute for Metabolic Optimization, Brazil; Bariatric Surgery Unit, Germany; Brigham and Women's Hospital, and Harvard Medical School, USA; WeightWorks Clinics and Allurion Clinics, The Netherlands; Iranian Hospital; Jordan Hospital; New Life Center, Guatemala; Ventura Advanced Surgical Associates, USA; Oswaldo Cruz German Hospital; Dr. Federico Abete Hospital for Trauma and Emergency; Rovigo Hospital; AZ Sint Jan Brugge-Oostende, Belgium; Bariatrics and Robotics Surgery Center, India; Mohak Bariatric and Robotic Center, India; Ain Shams University; Makassed General Hospital; Yotsuya Medical Cube, Japan; Department of Digestive Surgery, France; Walsall Healthcare NHS Trust; University of South Australia; Kular Research Institute; Sir H N Reliance Foundation Hospital; Al Sharq Hospital; China Medical University Shinchu Hospital; The American British Cowdray Medical Center, Mexico; South Tyneside and Sunderland Foundation NHS Trust; NMC Royal Hospital, Diakonissen Wehrle Private Hospital; Obesity Surgeons Mexico; Apollo Hospital New Delhi; St. Franziskus Hospital; Center for Laparoscopic Obesity Surgery, Las Vegas, USA; Aman Hospital; Turku University Hospital; National University of Singapore; Istanbul University, Istanbul; Obesity Goodbye Center, Mexico; University Hospital Vall Hebron; The First Affiliated Hospital of Jinan University; Medical University of Vienna

Publication date

2024-06-11

Subject

Surgery

Metadata

Show full item record

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.

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.

Type

Article