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Obesity Surgery
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11-06-2024 | Bariatric Surgery | Original Contributions

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus

Authors: Mohammad Kermansaravi, Sonja Chiappetta, Chetan Parmar, Miguel A. Carbajo, Mario Musella, Jean-Marc Chevallier, Rui Ribeiro, Almino C. Ramos, Rudolf Weiner, Abdelrahman Nimeri, Edo Aarts, Syed Imran Abbas, Ahmad Bashir, Estuardo Behrens, Helmuth Billy, Ricardo V. Cohen, Daniel Caina, Maurizio De Luca, Bruno Dillemans, Mathias A. L. Fobi, Manoel Galvao Neto, Khaled Gawdat, Mohamad Hayssam ElFawal, Kazunori Kasama, Radwan Kassir, Amir Khan, Lilian Kow, Kul Deepak Singh Kular, Muffazal Lakdawala, Laurent Layani, Wei-Jei Lee, Enrique Luque-de-León, Kamal Mahawar, Hazem Almomani, Karl Miller, Juan Carlos Olivares González, Arun Prasad, Karl Rheinwalt, Robert Rutledge, Bassem Safadi, Paulina Salminen, Asim Shabbir, Halit Eren Taskin, Jose Sergio Verboonen, Ramon Vilallonga, Cunchuan Wang, Scott A. Shikora, Gerhard Prager

Published in: Obesity Surgery | Issue 7/2024

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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.

Graphical Abstract

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Metadata
Title
Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus
Authors
Mohammad Kermansaravi
Sonja Chiappetta
Chetan Parmar
Miguel A. Carbajo
Mario Musella
Jean-Marc Chevallier
Rui Ribeiro
Almino C. Ramos
Rudolf Weiner
Abdelrahman Nimeri
Edo Aarts
Syed Imran Abbas
Ahmad Bashir
Estuardo Behrens
Helmuth Billy
Ricardo V. Cohen
Daniel Caina
Maurizio De Luca
Bruno Dillemans
Mathias A. L. Fobi
Manoel Galvao Neto
Khaled Gawdat
Mohamad Hayssam ElFawal
Kazunori Kasama
Radwan Kassir
Amir Khan
Lilian Kow
Kul Deepak Singh Kular
Muffazal Lakdawala
Laurent Layani
Wei-Jei Lee
Enrique Luque-de-León
Kamal Mahawar
Hazem Almomani
Karl Miller
Juan Carlos Olivares González
Arun Prasad
Karl Rheinwalt
Robert Rutledge
Bassem Safadi
Paulina Salminen
Asim Shabbir
Halit Eren Taskin
Jose Sergio Verboonen
Ramon Vilallonga
Cunchuan Wang
Scott A. Shikora
Gerhard Prager
Publication date
11-06-2024
Publisher
Springer US
Published in
Obesity Surgery / Issue 7/2024
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-024-07345-8

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