Retrospective Cohort Study Comparing Laparoscopic One Anastomosis Gastric Bypass and Single Anastomosis Sleeve Ileal for the Treatment of Patients with Morbid Obesity and Effect on GLP-1 level: Short Term Outcomes.

Document Type : Original Article

Authors

1 Department of General Surgery, Faculty of Medicine, Port Said University, Egypt

2 Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt

3 Department of General Surgery, Faculty of Medicine, Kafr Elshiekh University, Egypt

Abstract

Introduction: Bariatric surgery is an effective treatment for morbid obesity, though the optimal procedure remains
debated. Laparoscopic one-anastomosis gastric bypass (LOAGB) and single-anastomosis sleeve ileal (SASI) bypass
differ in their metabolic effects, particularly regarding glucagon-like peptide-1 (GLP-1), a key regulator of glycemic
control.
Aim of work: To compare the impact of LOAGB and SASI on weight loss, glycemic improvement, GLP-1 levels,
diabetes remission, comorbidity resolution, and postoperative complications.
Patients and methods: This retrospective cohort study included patients with severe obesity who underwent
LOAGB or SASI. Outcomes at 12 months included %EWL, %EBMIL, HbA1c reduction, GLP-1 response, comorbidity
resolution, and complications.
Results: Both groups achieved significant weight loss with no difference in %EWL (80.9% vs. 81.2%, p = 0.738)
or %EBMIL (93.7% vs. 92.8%, p = 0.285). GLP-1 levels (pmol/L) at 6 months were significantly higher in SASI
(11.63 vs. 10.48 pmol/L, p = 0.01). HbA1c decreased in both groups (LOAGB: 10.46% to 5.90%; SASI: 9.89%
to 5.12%, p = 0.461). GLP-1 positively correlated with weight loss (r = 0.74) and inversely with HbA1c (r =
-0.79), more pronounced in SASI. Diabetes remission was higher in SASI (100% vs. 87.5%), as was hypertension
resolution (100% vs. 88.9%). Complication rates, operative time, and hospital stay were similar.
Conclusion: LOAGB and SASI both provide effective weight loss and metabolic improvements. SASI yields higher
GLP-1 levels and superior diabetes remission, suggesting enhanced metabolic benefits. Further studies are needed
to confirm long-term outcomes.

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