J Metab Bariatr Surg.  2016 Dec;5(2):45-52. 10.0000/jmbs.2016.5.2.45.

A Safe and Efficacious Alternative to Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity and Type 2 Diabetes - One Anastamosis / Mini Gastric Bypass

• Tan CH
• Park YS
• Kim DW
• Lee Y
• Ahn SH
• Park DJ
• Kim HH
• Cheng A

• KMID: 2368192
• DOI: http://doi.org/10.0000/jmbs.2016.5.2.45

Abstract

Roux-en-y gastric bypass (RYGB) is currently used to treat obesity and metabolic syndrome. It is however technically challenging with a steep learning curve and long operating times. Laparoscopitc mini-gastric bypass (LMGB) is another surgical method that is acclaimed to achieve similar efficacy and yet safe with acceptable complication rates. We reviewedcurrent literature on LMGB on its efficacy and safety profile. Comprehensive search of available literature using a combination of key words was performed, looking out for efficacy and safety end points. Efficacy end points include excess weight loss, change in body mass index (BMI), resolution of metabolic syndrome or T2DM remission. Safety end points include mortality and morbidity rates, short and long term complications. 18 studies were selected with a total of 9392 patients. Follow up range was from 1 year to 6 years with majority of studies achieving 57%-92% excess weight loss (%EWL) within 1 year. Remission of T2DM rates were mostly more than 84%. Several studies reported better %EWL and T2DM remission when compared to SG and RYGB. Overall mortality rate was 0.152%. Morbidity rates vary from 2.7%-12.5%. Some studies reported lower mortality and complication rates in LMGB when compared to SG and RYGB. In summary, MGB is a safe and effective metabolic-bariatric procedure in treating morbid obesity and T2DM. It should be considered an alternative to standard RYGB. Risk of bile reflux, marginal ulcer and anemia needs to be explained to the patient when counselling for such procedure.

Keyword

Single anastamosis bypass; Gastric bypass; Roux-en-y gastric bypass; Mini gastric bypass; One anastamosis bypass

MeSH Terms

Anemia
Bile Reflux
Body Mass Index
Follow-Up Studies
Gastric Bypass*
Humans
Learning Curve
Methods
Mortality
Obesity
Obesity, Morbid*
Peptic Ulcer
Weight Loss