Fewer patients with insufficient weight loss after one anastomosis gastric bypass compared to Roux-en-Y gastric bypass after 5 years of follow-up

This study aims to give a comprehensive overview of the one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) during 5 years of follow-up in terms of weight loss, the remission of obesity-associated diseases and complications. We performed a retrospective cohort study, with a 1:1 propensity-score matched (PSM) comparison between all adult patients who underwent a primary OAGB or RYGB in 2016. Patients with a body mass index (BMI) ≥50 kg/m² were excluded. In total, 372 patients underwent OAGB and 113 patients RYGB. After performing a 1:1 PSM, we obtained two nearly identical cohorts of 113 patients. After OAGB, the percentage of total weight loss (%TWL) was significantly higher during 5 years of follow-up. Also, more patients after OAGB had a successful weight loss (TWL > 20%) after 5 years (86% vs. 72%; p = .019). The remission of obesity-associated diseases and short-term complications did not differ between both procedures. Persistent reflux was the reason for conversion to RYGB in 11.3% of the patients after OAGB. More internal herniations were seen after RYGB (10.4% vs. 1.9%; p = .010). Overall, the proportion of patients with major mid-term complications did not differ between both procedures. In conclusion, OAGB resulted in more weight reduction and especially fewer patients with insufficient weight loss during 5 years of follow-up, while remission of obesity-associated diseases remained the same.