Long-Term Outcomes of One-Anastomosis Gastric Bypass: 10+ Year Follow-Up Review

Overview

This systematic review of five studies including 1,750 patients demonstrates that One Anastomosis Gastric Bypass (OAGB) provides sustained weight loss and high remission rates of type 2 diabetes and hypertension at 10 years post-surgery. Conversion surgery rates remain low, and long-term safety concerns such as bile reflux and nutritional deficiencies are better characterized with extended follow-up.

Background

One Anastomosis Gastric Bypass (OAGB) is a widely performed metabolic bariatric procedure characterized by a single gastrojejunal anastomosis and shorter operative time. Since its introduction in 1997, OAGB has gained popularity globally, accounting for up to 16% of bariatric surgeries in some regions. Long-term data are essential to evaluate its durability, safety, and metabolic benefits, especially given initial concerns about bile reflux and nutritional complications. This review synthesizes outcomes from studies with at least 10 years of follow-up to inform clinical practice.

Data Highlights

Key Findings

• Mean total weight loss at 10 years post-OAGB ranges from 27.6% to 32.1%, indicating durable and clinically meaningful weight reduction.
• High remission rates for type 2 diabetes (79.4%) and hypertension (79.9%) are sustained at 10 years.
• Remission of gastroesophageal reflux disease varies between 22% and 48%, while obstructive sleep apnea remission ranges from 73.1% to 90%.
• OAGB is performed as a revisional procedure in up to 49.6% of patients in some cohorts, reflecting its role in conversion surgery.
• Conversion to other surgical procedures after OAGB is relatively low, averaging 5.2% over 10 years.
• Long-term follow-up clarifies concerns about bile reflux and nutritional deficiencies, supporting the procedure’s safety profile.

Clinical Implications

OAGB offers a durable option for sustained weight loss and metabolic disease remission with a relatively low rate of conversion surgery over a decade. Clinicians should monitor patients long-term for nutritional deficiencies and bile reflux, but current evidence supports OAGB as a safe and effective metabolic bariatric procedure. Its use as both primary and revisional surgery expands treatment options for obesity and related comorbidities.

Conclusion

Long-term data confirm that OAGB provides sustained weight loss and metabolic benefits with manageable complication rates, reinforcing its role in modern bariatric surgery. Extended follow-up enhances understanding of its risk-benefit profile, supporting broader clinical adoption.

References

1. Rutledge R, 1997 -- One Anastomosis Gastric Bypass Description
2. IFSO Global Survey, Recent Data -- Bariatric Procedure Prevalence
3. Vitiello et al., 2023 -- Long-Term Outcomes of OAGB