Sleeve Gastrectomy Compared to One Anastomosis Gastric Bypass: Three-Year Follow-Up in an Algerian Cohort

Background: Sleeve Gastrectomy (SG) and One-Anastomosis Gastric Bypass (OAGB) are common procedures for the treatment of severe obesity in Algeria. However, no studies compared their outcomes in patients from Algeria. We aim to compare outcomes of SG and OAGB Methods: This is a retrospective single-center study of patients undergoing SG or OAGB from October 2020 to October 2023. Outcomes were evaluated for weight loss (BMI, %EWL, %TWL), resolution of obesity complications (type 2 diabetes, hypertension, hyperlipidemia, sleep apnea), complications using the Clavien-Dindo classification, and nutritional deficiencies. Results: This study included 204 patients (102 SG and 102 OAGB) selected from a total of 352 who underwent one of these procedures during the study period. Patients who had OAGB had a higher incidence of GERD, Type 2 DM, and BMI > 40 compared to patients after SG. Patients after OAGB achieved greater and more sustained weight loss compared to SG, reaching lower BMI (28.3 vs. 31.8 kg/m²), higher %EWL (88.6% vs. 74%), and %TWL (37.8% vs. 30.7%) at 36 months (all p < 0.001). T2DM remission was superior after OAGB (82% vs. 61%, p = 0.003), while remission of hypertension, hyperlipidemia, and sleep apnea was similar. Overall complication rates were similar (14.7% vs. 19.6%, p = 0.4), but de novo GERD was significantly more frequent after SG (12% vs. 1%, p = 0.001). Nutritional deficiencies and anemia were rare after OAGB with a 150-cm biliopancreatic limb; two patients developed hypoalbuminemia after OAGB. No conversions or mortality occurred. Follow-up was available for 87% of patients. Conclusion: In this Algerian cohort, patients after OAGB sustained more weight loss and T2DM remission, with less GERD, compared to SG, three years after surgery.