Long-Term Outcomes of Laparoscopic Sleeve Gastrectomy Versus One-Anastomosis Gastric Bypass: A Retrospective Comparative Study with ≥ 7 Years Follow-Up

To compare the long-term outcomes of laparoscopic sleeve gastrectomy (LSG) and one-anastomosis gastric bypass (OAGB) in patients with morbid obesity.

This retrospective study included 105 patients who underwent LSG (n=57) or OAGB (n=48) with a minimum follow-up of 7 years. Preoperative and postoperative weight parameters, obesity related diseases, and complications were analyzed.

No significant differences were observed between the groups in terms of demographic characteristics . The follow-up duration in the OAGB group was found to be significantly longer compared to the SG group. Both procedures resulted in significant and sustained weight loss. However, OAGB was associated with superior outcomes in terms of excess weight loss (EWL>50%: 95.8% vs. 73.6%, p<0.05) and total weight loss (TWL>20%). Remission rates of type 2 diabetes were similar (OAGB: 84%, LSG: 64%; p=0.187). OAGB showed significantly better outcomes in hypertension remission (100% vs. 71%; p<0.05) and reduction in total cholesterol levels. A total of 15 complications were identified in the patient cohort.Anemia (n:9) was more common after OAGB (14.5% vs. 3.5%). Other complications included internal hernia (n:1), ulcer bleeding (n:1), and persistent vomiting (n:2) in the OAGB group; and staple line leak (n:1) and hepatic abscess (n:1) in the LSG group.

Both LSG and OAGB are effective in achieving long-term weight loss and improving obesity-related comorbidities. OAGB offers greater weight reduction and better metabolic outcomes, particularly in hypertension and dyslipidemia. However, its higher rate of nutritional complications requires careful long-term follow-up.