Effect of one anastomosis gastric bypass on liver function tests: A comparison between 150 cm and 200 cm biliopancreatic limbs

J Minim Access Surg. 2022 Jan-Mar;18(1):38-44. doi: 10.4103/jmas.JMAS_249_20.

Abstract

Context: Some studies have shown that one anastomosis gastric bypass (OAGB) results in the derangement of liver function tests (LFTs). We wanted to study this in our patients.

Aims: The aims are to study the effect of OAGB on LFTs and to compare the effect of a biliopancreatic limb (BPL) of 150 cm (OAGB-150) to a BPL of 200 cm (OAGB-200).

Settings and design: The study was a retrospective cohort study conducted at a university hospital.

Materials and methods: Information was obtained from our prospectively maintained database and hospital's computerised records.

Statistical analysis: A P < 0.05 was regarded statistically significant; however, given the number of variables examined, findings should be regarded as exploratory.

Results: A total of 405 patients underwent an OAGB-200 (n = 234) or OAGB-150 (n = 171) in our unit between October 2012 and July 2018. There were significant improvements in gamma-glutamyl transpeptidase (GGT) levels at 1 and 2 years after OAGB-200 and significant worsening in the levels of alkaline phosphatase (ALP) and albumin at 1 and 2 years. There was a significant improvement in GGT levels at 1 and 2 years after OAGB-150 and in alanine transaminase levels at 1 year. There was a significant worsening in ALP and albumin levels at both follow-up points in this group. OAGB-150 group had a significantly lower bilirubin level at 1 year and significantly fewer abnormal ALP values at 2 years in comparison with OAGB-200 patients.

Conclusions: This exploratory study demonstrates the overall safety of OAGB with regard to its effect on LFTs, with no remarkable difference between OAGB-150 and OAGB-200.

Keywords: Bariatric surgery; biliopancreatic limb length; liver function tests; mini-gastric bypass; obesity surgery; omega-loop gastric bypass; one anastomosis gastric bypass; single anastomosis gastric bypass.