Background

Bariatric metabolic surgery (BMS), including procedures like one-anastomosis gastric bypass (OAGB) and duodenal-jejunal bypass with sleeve gastrectomy (DJB-SG), has proven effective in achieving lasting weight loss and improving conditions associated with obesity. Despite its recognized success, there's a shortage of long-term follow-up data on OAGB and DJB-SG, prompting the need for further investigation. A study focused on 224 Taiwanese adult patients who underwent these procedures between 2011 and 2017. The primary aim was to evaluate the safety, effectiveness, and long-term impact of OAGB and DJB-SG on weight loss and type 2 diabetes (T2D) remission up to three years post-surgery. The secondary objective involved assessing changes in the 10-year risk of major adverse cardiovascular events (MACEs). Both groups exhibited significant improvements in BMI, T2D, hypertension, and dyslipidemia two years post-surgery, with some rebound in the third year. Risk predictions using Taiwan MACE and China-PAR models demonstrated substantial reductions in stroke and MACEs risks for both groups. Notably, stroke risk decreased from 54.0% to 8.5% in OAGB and 21.3% to 10.6% in DJB-SG, while MACEs risk dropped from 27.0% to 12.4% in OAGB and 21.2% to 12.0% in DJB-SG. In summary, both OAGB and DJB-SG resulted in sustained improvements in weight reduction, obesity-related comorbidities, and a notable reduction in the 10-year and lifetime risk of ASCVD, stroke, and MACEs three years after surgery.