One-anastomosis gastric bypass vs sleeve gastrectomy for diabetes remission and weight loss: A meta-analysis

doi:10.4240/wjgs.v17.i11.109426

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Nov 27, 2025 (publication date) through Nov 25, 2025

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Meta-Analysis

World J Gastrointest Surg. Nov 27, 2025; 17(11): 109426
Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.109426

One-anastomosis gastric bypass vs sleeve gastrectomy for diabetes remission and weight loss: A meta-analysis

Hyder Osman Mirghani

Hyder Osman Mirghani, Department of Internal Medicine, University of Tabuk, Tabuk 51941, Saudi Arabia

Author contributions: Mirghani HO conceived and designed the study, conducted the literature search, drafted and made critical revisions to the manuscript, and provided final approval of the version to be published.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Hyder Osman Mirghani, MD, Full Professor, Department of Internal Medicine, University of Tabuk, Prince Fahd Bin Sulta, Tabuk 51941, Saudi Arabia. s.hyder63@hotmail.com

Received: May 12, 2025
Revised: June 24, 2025
Accepted: September 15, 2025
Published online: November 27, 2025
Processing time: 198 Days and 21.8 Hours

Abstract

BACKGROUND

One-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) are surgical procedures increasingly performed for weight loss and to achieve remission of diabetes mellitus. Literature comparing the medium-term efficacy of these two procedures is scarce. As such, a meta-analysis comparing OAGB and SG in terms of diabetes remission (DR) and percentage of excess weight loss (EWL) is warranted.

AIM

To compare OAGB and SG in terms of DR and EWL% in the medium term.

METHODS

A comprehensive literature search was conducted in PubMed/MEDLINE, Cochran Library, and Web of Science for relevant articles, from inception through April 2025, using the keywords “one-anastomosis gastric bypass”, “sleeve gastrectomy”, “mini-gastric bypass”, “diabetes remission”, “one-anastomosis”, and “excess weight loss”. Clinical trials, prospective, retrospective and case-control studies were included; cross-sectional studies, case reports, editorials, and opinions were excluded. The Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale were used to assess the quality of included studies, and RevMan version 5.4 was used for data analyses.

RESULTS

A total of 1360 articles were identified, and 35 studies were retrieved of which 32 were included in the final analysis. Three full texts were excluded as they did not include data on DR or EWL%. OAGB achieved higher DR than SG at 1 year following surgery [odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.22-2.57, I² = 76%]. However, DR rates were similar at 3 years and 5 years following surgery (OR = 0.82, 95%CI: 0.61-1.10, I² = 23% and OR = 0.92, 95%CI: 0.31-2.72, I² = 75%, respectively). OAGB showed higher EWL% at 1 year (OR = 9.30, 95%CI: 6.45-12.15, I² = 91%), 3 years (OR = 10.02, 95%CI: 9.40-10.64, I² = 22%), and 5 years (OR = 11.61, 95%CI: 3.74-19.48, I² = 97%). OAGB showed higher late complications than adjustable SG. The results were not different in sub-group analysis including only clinical trials, observational studies, and removing studies including super-obese patients and studies contributing most to heterogeneity.

CONCLUSION

In the medium term, DR rates were similar between OAGB and SG; however, OAGB showed higher EWL% than SG, and late complications were higher in OAGB. Clinical trials investigating the predictors of DR and EWL% are recommended.

Keywords: One anastomosis gastric bypass; Sleeve gastrectomy; Diabetes remission; Excess weight loss; Meta-analysis

Core Tip: Obesity and diabetes are growing at an alarming rate. Bariatric surgery is an effective method for weight management and inducing diabetes remission (DR); therefore, choosing the correct type of bariatric surgery is important. Sleeve gastrectomy is the most frequently performed bariatric surgery, and one-anastomosis gastric bypass has seen an increase in popularity recently. Literature regarding the most effective bariatric surgery for weight reduction and DR is scarce. This review provides broader insights into one-anastomosis gastric bypass and sleeve gastrectomy in the medium term, including their impact on excess weight loss, DR, complications, mortality, and quality of life.