Reversing One-Anastomosis Gastric Bypass Surgery due to Severe and Refractory Hypoalbuminemia

Abstract

Background Laparoscopic one-anastomosis gastric bypass (LOAGB) has to be reverse under some circumstances. This study is aimed to introduce and review a series of LOAGB cases that had to be reversed to normal anatomy due to severe hypoalbuminemia and its related symptoms after a few months. Methods Patients who had LOAGB from 2014 to 2018 and then reversed after some months were included in this study. Their first and second surgical data were collected and reviewed for important and relevant information. Results From 846 cases of LOAGB, 12 patients reversed after a mean of 12.1 months. All of them were women with mean age of 46 years. All of the gastrojejunostomy anastomosis had been made 200 cm after the Treitz ligament, and all of the patients had at least 250 cm common channel. The mean excess body mass index loss before the reversal surgery was 107.7. None patients lost or died during the study. Conclusion Regarding anastomosis, 200 cm from Treitz ligament is not suitable for all of the patients and common channel more than 250 cm cannot prevent hypoalbuminemia. The surgeon should decide as quickly as possible whether his/her patients need reversal surgery or not. Appropriate patients should be selected for LOAGB.