Comparison of One-Year Outcomes in Sleeve Gastrectomy vs. One Anastomosis Gastric Bypass in a Single Bariatric Unit.

Introduction Sleeve gastrectomy (SG) is the most popular bariatric procedure worldwide in terms of numbers performed. However, there has been a rise in the popularity of the one anastomosis (mini) gastric bypass (OAGB). There have been various studies comparing the outcomes of SG vs OAGB and this study aims to add our experience and compare one-year outcome data between SG and OAGB in a single UK bariatric centre. Methods A retrospective search of our database between June 2021 and August 2023 was performed to identify those patients undergoing either laparoscopic SG or OAGB. Initial and one-year follow-up data was collected including percentage total weight loss (%TWL), percentage excess body weight loss (%EBWL), incidence of post-operative reflux, remission of co-morbidities (diabetes), glycated haemoglobin (HbA1c) changes, operating time and post-operative complications.  Results A total of 64 OAGB and 53 SG patients were identified in this time frame. Nineteen OAGB and 26 SG patients had one-year outcome data available and so were included in the final analysis. Pre-op BMI was significantly lower in the OAGB group (OAGB = 47.1, SG = 52.7, p<0.05). Initial age, rates of pre-operative gastro-oesophageal reflux symptoms and pre-operative diabetes were comparable. Regarding one-year outcomes, %EBWL was comparable, as was the length of stay, reduction in HbA1c and resolution of diabetes. Operating time was significantly shorter in the SG group (OAGB = 140 mins, SG = 111 mins, p<0.05). While the number of patients with post-operative complications was the same in both groups, two patients in the OAGB group suffered from ulcer disease with one requiring a return to theatre for this. No patients in the SG group suffered from ulcer disease. One OAGB patient required conversion to Roux-en-Y gastric bypass (RYGB) for reflux, while three SG patients required conversion to RYGB for resistant reflux. Conclusion Both OAGB and SG patients in our centre have comparable outcomes with regard to excess body weight loss and resolution of diabetes. SG was quicker to perform. OAGB may be associated with higher rates of ulceration while SG may be associated with higher rates of treatment-resistant reflux requiring conversion surgery. The literature has revealed greater weight loss and increased rates of diabetes resolution with OAGB. This along with our findings will be considered when counselling our patients on the bariatric procedures available to them.