Systematic review of five-year outcomes after one-anastomosis gastric bypass.
Sergi Sanchez-Cordero, Ruth Lopez-Gonzalez, Rodrigo Hermoza et al.
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In 30 seconds
This systematic review assessed five-year outcomes after primary one-anastomosis gastric bypass (OAGB) in adults with BMI ≥ 35 kg/m². Seven studies contributed baseline data for 5524 patients, with complete five-year follow-up for 3735. The weighted mean total weight loss at five years was 33.2%; reported remission of type 2 diabetes was 77.4%. Complications included marginal ulcers, reflux, anemia, and hypoalbuminemia, with no procedure-related mortality reported. The authors judged the evidence limited and heterogeneous, leaving long-term safety and comparisons with other bariatric procedures uncertain.
Key findings
- At five years, mean total weight loss was 33.2%, mean excess weight loss was 74.2%, and mean BMI was 30.1 kg/m².
- Reported five-year remission rates were 77.4% for type 2 diabetes, 58.0% for hypertension, 71.9% for dyslipidemia, and 86.6% for obstructive sleep apnea.
- Complications included marginal ulcers, gastroesophageal reflux, anemia, and hypoalbuminemia; incidence varied, and only a minority required revisional surgery.
- No procedure-related mortality was observed in the included studies.
Why it matters
The review brings together reported five-year weight and metabolic outcomes, while highlighting that these results do not settle questions about longer-term nutritional and reflux-related safety. The evidence also does not establish whether OAGB is superior or equivalent to other malabsorptive procedures, so the findings should be interpreted as descriptive rather than definitive comparative evidence.
What to keep in mind
Only seven studies met inclusion criteria, and the authors describe the evidence as limited, heterogeneous, and sometimes conflicting. Long-term safety, particularly nutritional deficiencies and bile reflux, remains insufficiently characterized.