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Background <p>One-anastomosis gastric bypass (OAGB) is a widely performed bariatric procedure. The length of the biliopancreatic limb (BPL) is a key determinant of weight loss and metabolic effect, but excessively long limbs may predispose to malabsorptive complications. Long-term outcome data for fixed long BPLs remain limited.</p> Objective <p>To evaluate long-term severe complications requiring revisional surgery following OAGB with a fixed biliopancreatic limb length of 250 cm.</p> Methods <p>This multicentre retrospective cohort study included all consecutive patients who underwent primary OAGB with a 250-cm BPL between 2010 and 2020. Data were extracted from hospital electronic and paper records. Patients were invited for a structured clinical and biochemical assessment. Severe complications were predefined and reviewed by a multidisciplinary team. Outcomes of interest were severe complications requiring revisional surgery. Follow-up ranged from 7 to 15 years.</p> Results <p>Of 892 OAGB procedures performed during the study period, 97 patients (10.9%) underwent OAGB with a 250-cm BPL. Complete follow-up data were available for 78 patients (80.4%). Mean age was 47 years, mean preoperative BMI was 46.6 kg/m<sup>2</sup>, and 75.3% were female. Nineteen patients (24.3%) developed severe complications requiring revisional surgery. Indications included severe protein malnutrition (5.1%), refractory bile or acid reflux (6.4%), severe diarrhoea (6.4%), liver failure (2.5%), twisted gastrojejunostomy (2.5%), and excessive weight loss (1.3%). Revisions included conversion to sleeve gastrectomy, Roux-en-Y gastric bypass, or reversal to normal anatomy.</p> Conclusion <p>OAGB with a fixed biliopancreatic limb length of 250 cm was associated with a high rate of severe long-term complications requiring revisional surgery. These findings support cautious tailoring of BPL length and avoidance of routinely long limbs in OAGB.</p>

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Revisions of One Anastomosis Gastric Bypass with Biliopancreatic Limb of 250 cm Multicentre Retrospective Study with a Mean Follow-up of 11 years

  • 期刊论文

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  • 发表日期：

    2026年7月25日

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  • ABDULZAHRA Hussain,
  • Alaa AlWadees,
  • Samer AL Hakkak,
  • Tamer Habeeb,
  • Peter Vasas

摘要

Background

One-anastomosis gastric bypass (OAGB) is a widely performed bariatric procedure. The length of the biliopancreatic limb (BPL) is a key determinant of weight loss and metabolic effect, but excessively long limbs may predispose to malabsorptive complications. Long-term outcome data for fixed long BPLs remain limited.

Objective

To evaluate long-term severe complications requiring revisional surgery following OAGB with a fixed biliopancreatic limb length of 250 cm.

Methods

This multicentre retrospective cohort study included all consecutive patients who underwent primary OAGB with a 250-cm BPL between 2010 and 2020. Data were extracted from hospital electronic and paper records. Patients were invited for a structured clinical and biochemical assessment. Severe complications were predefined and reviewed by a multidisciplinary team. Outcomes of interest were severe complications requiring revisional surgery. Follow-up ranged from 7 to 15 years.

Results

Of 892 OAGB procedures performed during the study period, 97 patients (10.9%) underwent OAGB with a 250-cm BPL. Complete follow-up data were available for 78 patients (80.4%). Mean age was 47 years, mean preoperative BMI was 46.6 kg/m2, and 75.3% were female. Nineteen patients (24.3%) developed severe complications requiring revisional surgery. Indications included severe protein malnutrition (5.1%), refractory bile or acid reflux (6.4%), severe diarrhoea (6.4%), liver failure (2.5%), twisted gastrojejunostomy (2.5%), and excessive weight loss (1.3%). Revisions included conversion to sleeve gastrectomy, Roux-en-Y gastric bypass, or reversal to normal anatomy.

Conclusion

OAGB with a fixed biliopancreatic limb length of 250 cm was associated with a high rate of severe long-term complications requiring revisional surgery. These findings support cautious tailoring of BPL length and avoidance of routinely long limbs in OAGB.