Early safety outcomes of laparoscopic one anastomosis gastric bypass in patients with class III, IV, and V obesity

Nasser Sakran, Asnat Raziel, Keren Hod, Bella Azaria, Uri Kaplan

Research output: Contribution to journalArticlepeer-review


Background: The extremely obese patient deserves special consideration: significant comorbidities, technical difficulties, and increased postoperative morbidity and mortality are all expected in this patient population. The study compared early postoperative complications (≤30-day) following one-anastomosis gastric bypass (OAGB) morbidity in patients with morbid obesity class IV obesity, body mass index (BMI) ≥50–59.9 kg/m2, and class V obesity, BMI ≥60 patients. Methods: We retrospectively reviewed perioperative OAGB outcomes in three BMI groups. Operative time, length of stay (LOS), and overall early postoperative complication rates were studied. Patient-reported complications were ranked by Clavien–Dindo Classification (CDC). Results: Between January 2017–December 2021, consecutive patients with obesity class III (n = 2950), IV (n = 256), and V (n = 23) underwent OAGB. BMI groups were comparable in sex, age, and associated comorbidities. Mean operative time was significantly longer in the higher BMI groups: class III (66.5 ± 25.6 min), IV (70.5 ± 28.7 min), and V (80.0 ± 34.7 min), respectively (p = 0.018); no difference in LOS. In respective BMI classes, ≤30-day complication rates were 3.2%, 3.5%, and 4.3% (p = 0.926). The respective number of patients with CDC grades of one to two were 45 (1.5%), 6 (2.3%), and 1 (4.3%), p = 0.500; and in grade ≥3a, 25 (0.8%), 1 (0.4%), 0 (0.0%), p = 0.669. There was 0.06% mortality (n = 2 in 3229), both in BMI class III. Conclusions: OAGB is a safe BS procedure in patients with class III, IV, and V obesity in the perioperative term with comparable ≤30-day morbidity in the three BMI groups.

Original languageEnglish
Pages (from-to)1458-1466
Number of pages9
JournalWorld Journal of Surgery
Issue number6
Early online date9 Apr 2024
StatePublished - Jun 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).


  • Class III obesity
  • Class IV obesity
  • Class V obesity
  • bariatric surgery
  • early postoperative complications
  • one anastomosis gastric bypass


Dive into the research topics of 'Early safety outcomes of laparoscopic one anastomosis gastric bypass in patients with class III, IV, and V obesity'. Together they form a unique fingerprint.

Cite this