{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:08:45Z","timestamp":1782119325333,"version":"3.54.5"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: One anastomosis gastric bypass (OAGB) is safe and effective. Its strong malabsorptive component might cause severe protein\u2013energy malnutrition (PEM), necessitating revisional surgery. We aimed to evaluate the safety and outcomes of OAGB revision for severe PEM. Methods: This was a single-center retrospective analysis of OAGB patients undergoing revision for severe PEM (2015\u20132021). Perioperative data and outcomes were retrieved. Results: Ten patients underwent revision for severe PEM. Our center\u2019s incidence is 0.63% (9\/1425 OAGB). All patients were symptomatic. Median (interquartile range) EWL and lowest albumin were 103.7% (range 57.6, 114) and 24 g\/dL (range 19, 27), respectively, and 8\/10 patients had significant micronutrient deficiencies. Before revision, nutritional optimization was undertaken. Median OAGB to revision interval was 18.4 months (range 15.7, 27.8). Median BPL length was 200 cm (range 177, 227). Reversal (n = 5), BPL shortening (n = 3), and conversion to Roux-en-Y gastric bypass (RYGB) (n = 2) were performed. One patient had anastomotic leak after BPL shortening. No death occurred. Median BMI and albumin increased from 22.4 kg\/m2 (range 20.6, 30.3) and 35.5 g\/dL (range 29.2, 41), respectively, at revision to 27.5 (range 22.2, 32.4) kg\/m2 and 39.5 g\/dL (range 37.2, 41.7), respectively, at follow-up (median 25.4 months, range 3.1, 45). Complete resolution occurs after conversion to RYGB or reversal to normal anatomy, but not after BPL shortening. Conclusions: Revisional surgery of OAGB for severe PEM is feasible and safe after nutritional optimization. Our results suggest that the type of revision may be an important factor for PEM resolution. Comparative studies are needed to define the role of each revisional option.<\/jats:p>","DOI":"10.3390\/nu14112356","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:10:33Z","timestamp":1654560633000},"page":"2356","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Revisional Surgery of One Anastomosis Gastric Bypass for Severe Protein\u2013Energy Malnutrition"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4607-3462","authenticated-orcid":false,"given":"Adam","family":"Abu-Abeid","sequence":"first","affiliation":[{"name":"Division of General Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 6423906, Israel"},{"name":"Sackler\u2019s Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Or","family":"Goren","sequence":"additional","affiliation":[{"name":"Sackler\u2019s Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Division of Anesthesiology, Pain and Intensive Care, Tel Aviv Medical Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai Meron","family":"Eldar","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 6423906, Israel"},{"name":"Sackler\u2019s Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Vitiello","sequence":"additional","affiliation":[{"name":"Advanced Biomedical Sciences Department, Naples \u201cFederico II\u201d University, AOU \u201cFederico II\u201d\u2014Via S. Pansini 5, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Berardi","sequence":"additional","affiliation":[{"name":"Advanced Biomedical Sciences Department, Naples \u201cFederico II\u201d University, AOU \u201cFederico II\u201d\u2014Via S. Pansini 5, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Lahat","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 6423906, Israel"},{"name":"Sackler\u2019s Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danit","family":"Dayan","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 6423906, Israel"},{"name":"Sackler\u2019s Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s11695-021-05249-5","article-title":"The IFSO Worldwide One Anastomosis Gastric Bypass Survey: Techniques and Outcomes?","volume":"31","author":"Haddad","year":"2021","journal-title":"Obes. 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