Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus

Mohammad Kermansaravi; Sonja Chiappetta; Chetan Parmar; Miguel A. Carbajo; Mario Musella; Jean Marc Chevallier; Rui Ribeiro; Almino C. Ramos; Rudolf Weiner; Abdelrahman Nimeri; Edo Aarts; Syed Imran Abbas; Ahmad Bashir; Estuardo Behrens; Helmuth Billy; Ricardo V. Cohen; Daniel Caina; Maurizio De Luca; Bruno Dillemans; Mathias A.L. Fobi; Manoel Galvao Neto; Khaled Gawdat; Mohamad Hayssam ElFawal; Kazunori Kasama; Radwan Kassir; Amir Khan; Lilian Kow; Kul Deepak Singh Kular; Muffazal Lakdawala; Laurent Layani; Wei Jei Lee; Enrique Luque-de-León; Kamal Mahawar; Hazem Almomani; Karl Miller; Juan Carlos Olivares González; Arun Prasad; Karl Rheinwalt; Robert Rutledge; Bassem Safadi; Paulina Salminen; Asim Shabbir; Halit Eren Taskin; Jose Sergio Verboonen; Ramon Vilallonga; Cunchuan Wang; Scott A. Shikora; Gerhard Prager

doi:10.1007/s11695-024-07345-8

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus

Mohammad Kermansaravi, Sonja Chiappetta, Chetan Parmar, Miguel A. Carbajo, Mario Musella, Jean Marc Chevallier, Rui Ribeiro, Almino C. Ramos, Rudolf Weiner, Abdelrahman Nimeri, Edo Aarts, Syed Imran Abbas, Ahmad Bashir, Estuardo Behrens, Helmuth Billy, Ricardo V. Cohen, Daniel Caina, Maurizio De Luca, Bruno Dillemans, Mathias A.L. FobiManoel Galvao Neto, Khaled Gawdat, Mohamad Hayssam ElFawal, Kazunori Kasama, Radwan Kassir, Amir Khan, Lilian Kow, Kul Deepak Singh Kular, Muffazal Lakdawala, Laurent Layani, Wei Jei Lee, Enrique Luque-de-León, Kamal Mahawar, Hazem Almomani, Karl Miller, Juan Carlos Olivares González, Arun Prasad, Karl Rheinwalt, Robert Rutledge, Bassem Safadi, Paulina Salminen, Asim Shabbir, Halit Eren Taskin, Jose Sergio Verboonen, Ramon Vilallonga, Cunchuan Wang, Scott A. Shikora, Gerhard Prager

College of Medicine and Public Health

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.

Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus.

Results: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300–400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB.

Conclusion: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues.

Graphical Abstract: (Figure presented.).

Original language	English
Pages (from-to)	2399-2410
Number of pages	12
Journal	Obesity Surgery
Volume	34
Issue number	7
Early online date	11 Jun 2024
DOIs	https://doi.org/10.1007/s11695-024-07345-8
Publication status	Published - Jul 2024

Keywords

Conversion
Correction
OAGB
Reversal
Revision
Revisional bariatric surgery

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s11695-024-07345-8Licence: In Copyright

https://rdcu.be/dOClALicence: In Copyright

Cite this

Kermansaravi, M., Chiappetta, S., Parmar, C., Carbajo, M. A., Musella, M., Chevallier, J. M., Ribeiro, R., Ramos, A. C., Weiner, R., Nimeri, A., Aarts, E., Abbas, S. I., Bashir, A., Behrens, E., Billy, H., Cohen, R. V., Caina, D., De Luca, M., Dillemans, B., ... Prager, G. (2024). Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus. Obesity Surgery, 34(7), 2399-2410. https://doi.org/10.1007/s11695-024-07345-8

@article{ca966da391fd4975a8d4cdb5b5132cad,

title = "Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts{\textquoteright} Modified Delphi Consensus",

abstract = "Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method. Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus. Results: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300–400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB. Conclusion: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues. Graphical Abstract: (Figure presented.).",

keywords = "Conversion, Correction, OAGB, Reversal, Revision, Revisional bariatric surgery",

author = "Mohammad Kermansaravi and Sonja Chiappetta and Chetan Parmar and Carbajo, {Miguel A.} and Mario Musella and Chevallier, {Jean Marc} and Rui Ribeiro and Ramos, {Almino C.} and Rudolf Weiner and Abdelrahman Nimeri and Edo Aarts and Abbas, {Syed Imran} and Ahmad Bashir and Estuardo Behrens and Helmuth Billy and Cohen, {Ricardo V.} and Daniel Caina and {De Luca}, Maurizio and Bruno Dillemans and Fobi, {Mathias A.L.} and Neto, {Manoel Galvao} and Khaled Gawdat and ElFawal, {Mohamad Hayssam} and Kazunori Kasama and Radwan Kassir and Amir Khan and Lilian Kow and Kular, {Kul Deepak Singh} and Muffazal Lakdawala and Laurent Layani and Lee, {Wei Jei} and Enrique Luque-de-Le{\'o}n and Kamal Mahawar and Hazem Almomani and Karl Miller and Gonz{\'a}lez, {Juan Carlos Olivares} and Arun Prasad and Karl Rheinwalt and Robert Rutledge and Bassem Safadi and Paulina Salminen and Asim Shabbir and Taskin, {Halit Eren} and Verboonen, {Jose Sergio} and Ramon Vilallonga and Cunchuan Wang and Shikora, {Scott A.} and Gerhard Prager",

year = "2024",

month = jul,

doi = "10.1007/s11695-024-07345-8",

language = "English",

volume = "34",

pages = "2399--2410",

journal = "Obesity Surgery",

issn = "0960-8923",

publisher = "Springer ",

number = "7",

}

Kermansaravi, M, Chiappetta, S, Parmar, C, Carbajo, MA, Musella, M, Chevallier, JM, Ribeiro, R, Ramos, AC, Weiner, R, Nimeri, A, Aarts, E, Abbas, SI, Bashir, A, Behrens, E, Billy, H, Cohen, RV, Caina, D, De Luca, M, Dillemans, B, Fobi, MAL, Neto, MG, Gawdat, K, ElFawal, MH, Kasama, K, Kassir, R, Khan, A, Kow, L, Kular, KDS, Lakdawala, M, Layani, L, Lee, WJ, Luque-de-León, E, Mahawar, K, Almomani, H, Miller, K, González, JCO, Prasad, A, Rheinwalt, K, Rutledge, R, Safadi, B, Salminen, P, Shabbir, A, Taskin, HE, Verboonen, JS, Vilallonga, R, Wang, C, Shikora, SA & Prager, G 2024, 'Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus', Obesity Surgery, vol. 34, no. 7, pp. 2399-2410. https://doi.org/10.1007/s11695-024-07345-8

TY - JOUR

T1 - Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus

AU - Kermansaravi, Mohammad

AU - Chiappetta, Sonja

AU - Parmar, Chetan

AU - Carbajo, Miguel A.

AU - Musella, Mario

AU - Chevallier, Jean Marc

AU - Ribeiro, Rui

AU - Ramos, Almino C.

AU - Weiner, Rudolf

AU - Nimeri, Abdelrahman

AU - Aarts, Edo

AU - Abbas, Syed Imran

AU - Bashir, Ahmad

AU - Behrens, Estuardo

AU - Billy, Helmuth

AU - Cohen, Ricardo V.

AU - Caina, Daniel

AU - De Luca, Maurizio

AU - Dillemans, Bruno

AU - Fobi, Mathias A.L.

AU - Neto, Manoel Galvao

AU - Gawdat, Khaled

AU - ElFawal, Mohamad Hayssam

AU - Kasama, Kazunori

AU - Kassir, Radwan

AU - Khan, Amir

AU - Kow, Lilian

AU - Kular, Kul Deepak Singh

AU - Lakdawala, Muffazal

AU - Layani, Laurent

AU - Lee, Wei Jei

AU - Luque-de-León, Enrique

AU - Mahawar, Kamal

AU - Almomani, Hazem

AU - Miller, Karl

AU - González, Juan Carlos Olivares

AU - Prasad, Arun

AU - Rheinwalt, Karl

AU - Rutledge, Robert

AU - Safadi, Bassem

AU - Salminen, Paulina

AU - Shabbir, Asim

AU - Taskin, Halit Eren

AU - Verboonen, Jose Sergio

AU - Vilallonga, Ramon

AU - Wang, Cunchuan

AU - Shikora, Scott A.

AU - Prager, Gerhard

PY - 2024/7

Y1 - 2024/7

N2 - Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method. Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus. Results: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300–400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB. Conclusion: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues. Graphical Abstract: (Figure presented.).

AB - Purpose: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method. Methods: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus. Results: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300–400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB. Conclusion: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues. Graphical Abstract: (Figure presented.).

KW - Conversion

KW - Correction

KW - OAGB

KW - Reversal

KW - Revision

KW - Revisional bariatric surgery

UR - http://www.scopus.com/inward/record.url?scp=85195690600&partnerID=8YFLogxK

U2 - 10.1007/s11695-024-07345-8

DO - 10.1007/s11695-024-07345-8

M3 - Article

C2 - 38862752

AN - SCOPUS:85195690600

SN - 0960-8923

VL - 34

SP - 2399

EP - 2410

JO - Obesity Surgery

JF - Obesity Surgery

IS - 7

ER -

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus

Abstract

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this