One anastomosis gastric bypass: key technical features,a nd prevention and management of procedure-specific complications

Mahawar, Kamal, Parmar, Chetan and Graham, Yitka (2018) One anastomosis gastric bypass: key technical features,a nd prevention and management of procedure-specific complications. Minerva Chirugia, 74 (2). pp. 126-136. ISSN 0026-4733

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Abstract

NTRODUCTION: One anastomosis gastric bypass (OAGB) is now a recognized mainstream bariatric procedure being adopted by an increasing number of surgeons. The purpose of this review was to present an evidence-based summary of its key technical aspects and prevention and management of its specific complications.
EVIDENCE ACQUISITION: We examined PubMed for all published articles on OAGB, including the ones published under one of its various other names.
EVIDENCE SYNTHESIS: An ideal OAGB procedure has a long, narrow pouch constructed carefully to avoid going too close to the greater curvature of the stomach especially at the bottom of the pouch and maintains a safe distance from the angle of His. A bilio-pancreatic limb length of 150 cm appears to be safest and a limb length of >200 cm is associated with a significantly increased incidence of protein-calorie malnutrition. We recommend routine closure of Petersen’s space to prevent Petersen’s hernia and suggest a protocol for micronutrient supplementation. This review also presents evidence-based algorithms for prevention and management of marginal ulcers, protein-calorie malnutrition, and gastroesophageal reflux disease after OAGB. We suggest lifelong supplementation with two multivitamin/mineral supplements (each containing at least 1.0 mg copper and 15 mg zinc) daily, 1.5 mg vitamin B12 orally daily or 3-monthly injection with 1 mg vitamin B12, 120 mg elemental iron daily, 1500 mg elemental calcium daily, and 3000 international units of vitamin D daily.
CONCLUSIONS: This review examines key technical steps of OAGB. We also discuss how to prevent and manage its specific complications.

Item Type: Article
Subjects: Sciences > Nursing
Divisions: Faculty of Health Sciences and Wellbeing
Related URLs:
Depositing User: Yitka Graham
Date Deposited: 01 Aug 2018 10:15
Last Modified: 14 Mar 2019 12:10
URI: http://sure.sunderland.ac.uk/id/eprint/9766

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