Laparoscopic Reversion of One-Anastomosis Gastric Bypass to Normal Anatomy: Case Series and Literature Review

Case series Patients: Female, 40-year-old • Female, 30-year-old • Female, 40-year-old • Female, 28-year-old • Female, 52-year-old Final Diagnosis: Revision bariatric surgery Symptoms: Biliary reflux • depression • edema • food intolerance • gastritis • liver failure • neuropathy • social pressure Medication: — Clinical Procedure: — Specialty: Surgery OBJECTIVE: Unusual or unexpected effect of treatment BACKGROUND: Revisional bariatric surgeries to other restrictive or malabsorptive procedures are considered for inadequate weight reduction, weight regains, or complications. Literature on the application of reversion of one-anastomosis gastric bypass (OAGB) to normal anatomy is limited. We aimed to report our experiences with 5 OAGB reversion surgeries to normal anatomy that were conducted for different reasons. CASE REPORTS: Case 1: A 40-year-old woman underwent OAGB. She had peripheral neuropathy, lower limb edema, food intolerance, and biliary reflux. For those reasons, we performed revisional surgery. Case 2: A 30-year-old woman underwent OAGB. She had tiredness, dizziness, multiple fainting, and lower limb edema. Laboratory results showed hypoglycemia, mild hypoproteinemia, and proteinuria. Dietary instructions were unsuccessful. Therefore, we performed revisional surgery. Case 3: A 40-year-old woman underwent OAGB. She had reached a body mass index (BMI) of 19, which was not appreciated by her social contacts and caused her to experience depression. After a psychiatric assessment, she insisted on revisional surgery. Case 4: A 28-year-old woman underwent OAGB. Her BMI was 18, which was not accepted by her spouse, who criticized her body image. For that, we did revisional surgery. Case 5: A 52-year-old woman with hypothyroidism underwent OAGB. She had poor compliance with dietary instructions, complicated by liver failure, which was conservatively managed. She underwent revisional surgery after optimizing her condition. She was discharged in stable condition. CONCLUSIONS: A multidisciplinary team should evaluate patients, and the decision to revise should come only after the failure of all conservative management methods.