Mid to Long-Term Endoscopic Findings Following Conversion From Sleeve Gastrectomy to One-Anastomosis Gastric Bypass

Introduction

One anastomosis gastric bypass (OAGB) is an option to address recurrent weight gain (RWG) or suboptimal clinical response (SoCR) after sleeve gastrectomy (SG). The need for endoscopic follow-ups in the mid- and long-term after conversional OAGB is less discussed. This study aims to assess the mid- and long-term endoscopic findings in patients undergoing conversional OAGB following SG.

Methods

A prospectively collected dataset from a retrospective study was analyzed in an academic fellowship-training hospital for patients who underwent conversion from SG to OAGB. Patients with pre- and post-operative esophagogastroduodenoscopy (EGD) results and at least 1 year of follow-up were included.

Results

A total of 108 patients underwent conversional OAGB following SG to treat RWG or SoCR. The patients were invited for follow-up EGD. A total of 40 of 108 patients accepted to undergo EGD. Of 40 patients (mean age: 42.45 ± 9.93 years), 32 (80%) were female. The mean follow-up period was 4.3 years. Significant BMI reduction was observed (mean BMI decreased from 46.58 to 34.04 kg/m², p < 0.001). Endoscopic findings: 10% developed de novo non-erosive reflux disease (NERD), 2.6% developed de novo esophagitis B, and one patient had bile reflux post-operatively. No esophagitis C, D, or Barrett's esophagus was observed. Marginal ulcers were seen in 10% post-conversion.

Discussion

Conversion of SG to OAGB effectively achieves significant weight loss. However, a mild risk remains for developing marginal ulcers and de novo esophagitis. OAGB is a promising conversional option to address RWG without any significant EGD pathological consequences in the mid to long term.