Our Summary

The research focuses on a type of weight loss surgery called One Anastomosis Gastric Bypass (OAGB) and the complications it can cause, specifically severe protein-energy malnutrition (PEM), which occasionally requires further surgery. In the study, they analyzed the results of patients who had to undergo additional surgery due to severe PEM after an OAGB from 2015 to 2021.

Only ten patients needed this extra surgery, which is less than 1% of all the OAGB surgeries performed in the center. All of these patients were showing symptoms of severe PEM, such as significant weight loss and low protein level in the blood. Additionally, most of these patients had notable deficiencies in certain nutrients.

Before the revision surgery, the patients’ nutritional status was improved. The methods of the revision surgery included reversing the previous surgery, shortening the bypassed part of the stomach, or converting the surgery type to a different weight-loss surgery called Roux-en-Y gastric bypass. The study found that the patients’ protein level and weight increased after the revision surgery.

The researchers concluded that revision surgery is a viable and safe option for dealing with severe PEM after an OAGB, but the type of revision surgery can play a critical role in the resolution of PEM. More studies are needed to better understand which type of revision surgery is the best option.

FAQs

  1. What complications can arise from the One Anastomosis Gastric Bypass (OAGB) surgery?
  2. What is the purpose of the revision surgery after OAGB?
  3. How is the type of revision surgery decided for patients with severe PEM after an OAGB?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric bypass is to closely monitor their nutritional intake and follow-up regularly with their healthcare provider to ensure they are getting the necessary nutrients post-surgery. It is important to take any symptoms of severe protein-energy malnutrition seriously and seek medical attention promptly if they occur. Additionally, patients should be aware that revision surgery may be necessary in rare cases of severe complications, but it can help improve nutritional status and overall health.

Suitable For

Patients who are typically recommended for gastric bypass surgery, including OAGB, are those who have a BMI of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. These patients have often tried other weight loss methods without success and are at risk for serious health complications due to their obesity.

It is important for patients considering gastric bypass surgery to undergo a thorough evaluation by a multidisciplinary team, including a surgeon, dietitian, psychologist, and other healthcare professionals, to determine if they are suitable candidates for the procedure. Patients with severe protein-energy malnutrition after OAGB may require revision surgery to address their nutritional deficiencies and improve their overall health.

Timeline

In summary, a patient before gastric bypass surgery undergoes a thorough evaluation by a healthcare team to determine if they are a suitable candidate for the procedure. They may also undergo preoperative counseling to understand the risks and benefits of the surgery. After the surgery, patients typically experience rapid weight loss, changes in their diet and eating habits, and improvements in their overall health. However, in rare cases, patients may develop complications such as severe protein-energy malnutrition, which may require further surgery to address.

The timeline for a patient experiencing severe PEM after OAGB surgery involves showing symptoms such as significant weight loss, low protein levels in the blood, and deficiencies in certain nutrients. Following this, the patient undergoes revision surgery to address the severe PEM. After the revision surgery, the patient’s nutritional status is improved, and their protein levels and weight increase. The type of revision surgery performed can impact the resolution of severe PEM, with further research needed to determine the best approach for these cases.

What to Ask Your Doctor

  1. What are the potential complications of One Anastomosis Gastric Bypass (OAGB) surgery, specifically severe protein-energy malnutrition (PEM)?

  2. How common is severe PEM after OAGB surgery, and what are the warning signs and symptoms to look out for?

  3. What steps can be taken to prevent severe PEM after OAGB surgery, such as monitoring nutritional status and supplementation?

  4. If severe PEM does occur after OAGB surgery, what are the treatment options available, including the possibility of revision surgery?

  5. What are the different types of revision surgery that can be performed for severe PEM after OAGB, and how do they differ in terms of effectiveness and safety?

  6. What are the potential risks and benefits of undergoing revision surgery for severe PEM after OAGB, and how can the patient prepare for this procedure?

  7. What is the success rate of revision surgery for severe PEM after OAGB, and what factors can affect the outcome of the procedure?

  8. How long is the recovery period after revision surgery for severe PEM after OAGB, and what post-operative care and follow-up appointments are necessary?

  9. Are there any lifestyle changes or dietary modifications that should be implemented after undergoing revision surgery for severe PEM after OAGB to prevent future complications?

  10. Are there any ongoing research studies or clinical trials investigating the best approaches for managing severe PEM after OAGB surgery, and how can patients stay informed about new developments in this field?

Reference

Authors: Abu-Abeid A, Goren O, Eldar SM, Vitiello A, Berardi G, Lahat G, Dayan D. Journal: Nutrients. 2022 Jun 6;14(11):2356. doi: 10.3390/nu14112356. PMID: 35684155