One-anastomosis gastric bypass vs sleeve gastrectomy for complications, perioperative status, and quality of life: Meta-analysis

Table 1 Complications in one-anastomosis gastric bypass and sleeve gastrectomy

Ref.	Age, OAGB vs SG, years	BMI, OAGB vs SG	Study type	Country	Study duration, years	SG, events	SG, total	OAGB, events	OAGB, total
Abouelela et al[23], 2020	44.87 ± 10.34 vs 45.11 ± 9.09	65.12 ± 5.89 vs 67.12 ± 3.95	Retrospective	Egypt	1	2	25	2	25
Bhandari et al[24], 2019	42.41 ± 11.0 vs 45.85 ± 12.2	54.23 ± 3.69 vs 56.39 ± 6.11	Retrospective	India	3	3	227	8	124
Das et al[25], 2024	47.1 vs 46.7	47.1 ± 9.75 vs 52.7 ± 7.17	Retrospective	Pakistan	2.16	4	26	4	19
Jammu and Sharma[26], 2016	38 vs 23	42.5 vs 35	Prospective	India	7	12	339	0	473
Jung et al[27], 2022	Matched	Matched	Retrospective	Canada	5	17	341	23	341
Kular et al[28], 2014	Not mentioned	Not mentioned	Retrospective	India	1.5	26	118	14	104
Lee et al. 2015[29]	35.9 ± 9.1 vs 35.9 ± 9.1	37.5 ± 6.1 vs 37.4 ± 5.9	Retrospective	Taiwan	6	8	519	10	519
Litmanovich et al[30], 2025	36.7 ± 13.5 vs 42.7 ± 15.2	52.2 ± 2.7 vs 55 ± 5.4	Retrospective	Israel	10	11	76	5	45
Madhok et al[31], 2016	51 ± 10.5 vs 45 ± 9.75	65 ± 9 vs 67 ± 6	Retrospective	United Kingdom	2	8	56	2	19
Musella et al[32], 2014	49.2 ± 9.1 vs 48.5 ± 8.7	48.1 ± 7.8 vs 48.3 ± 9.2	Retrospective	Multi-nation	1.5	20	175	3	80
Plamper et al[33], 2017	43.4 ± 11.2 vs 43.2 ± 11.1	54.6 ± 10.3 vs 54.1 ± 6.6	Retrospective	Germany	1	11	118	5	169
Plamper et al[34], 2023	42 ± 11 vs 44 ± 11	50.97 ± 7.31 vs 54.21 ± 10.07	Retrospective	Germany	5	133	241	253	911
Poljo et al[35], 2021	45.0 ± 9.1 vs 42.5 ± 10.2	42.1 ± 5.1 vs 46.7 ± 8.0	Retrospective	Austria	1.8	3	50	4	77
Rajan et al[36], 2020	42.3 ± 10.7 vs 39.2 ± 11.2	52.8 ± 1.5 vs 60.9 ± 9.3	Retrospective	Malaysia	1	1	27	0	3
Roushdy et al[37], 2020	33.8	48.6	Trial	Egypt	1	1	20	6	20
Schmitz et al[38], 2022	39.11 ± 0.9 vs 41.57 ± 1.07	64.14 ± 0.3 vs 66.91 ± 0.6	Retrospective	Germany	12	53	93	69	150
Singhal et al[39], 2022	40 vs 38	43.11 vs 41.91	Retrospective	Multi-national	1.5	233	3983	53	702
Singla et al[40], 2019	39.56 ± 9.77 vs 39.89 ± 11.75	44.32 ± 7.88 vs 44.57 ± 7.16	Retrospective	India	1	2	50	0	25
Singla et al[41], 2024	35 vs 37	61 vs 63.2	Retrospective	India	5	0	56	0	13
Soong et al[42], 2021	31.9 ± 9.7 vs 33.0 ± 10.0	56.2 ± 5.8 vs 55.9 ± 5.5	Retrospective	Taiwan	14	6	190	21	246
Tasdighi et al[43], 2022	40.4 ± 10.9 vs 39.2 ± 12.6	54.9 ± 4.6 vs 54.3 ± 3.9	Retrospective	Iran	3	15	348	32	209
Vrakopoulou et al[44], 2021	46.6 ± 7.8 vs 45.9 ± 7.5	52.7 ± 10.8 vs 52.2 ± 8.6	Retrospective	Greece	1.5	2	28	1	25
Alkhalifah et al[45], 2018	35.2 ± 10.1 vs 33.8 ± 10.4	36.4 ± 7.6 vs 40.4 ± 7.7	Prospective	Taiwan	5	Not assessed	1731	Not assessed	1107
Seetharamaiah et al[46], 2017	39.9 ± 11.75 vs 42.9 ± 14.02	39.9 ± 11.7 vs 42.9 ± 14.0	Trial	India	3	Not assessed	100	Not assessed	101
Shivakumar et al[47], 2018	39.9 ± 11.75 vs 42.9 ± 14.02	44.6 ± 7.16 vs 44.3 ± 7.88	Trial	India	3	Not assessed	100	Not assessed	101
Jain et al[48], 2021	42.9 ± 14.0 vs 39.9 ± 11.7	44.3 ± 7.88 vs 44.5 ± 7.16	Trial	India	5	Not assessed	47	Not assessed	49
Musella et al[49], 2021	18-65	48.5 ± 8.8 vs 47.5 ± 7.3	Trial	Italy	1	Not assessed	28	Not assessed	30
Vitiello et al[50], 2023	39.5 ± 10.1 vs 39.4 ± 9.9	44 ± 6 vs 44.3 ± 5.4	Retrospective	Italy	3	Not assessed	109	Not assessed	119
Abu Sneineh et al[51], 2021	Not assessed	Not assessed	Retrospective	Israel	10	Not assessed	98	Not assessed	42
Genco et al[52], 2021	Not assessed	45.2 ± 6.9 vs 46.7 ± 6.7	Prospective	Italy	10	Not assessed	48	Not assessed	59
Gambardella et al[53], 2024	40.1 ± 5.1 vs 38.9 ± 4.6	47.1 ± 2.3 vs 46.2 ± 3.6	Retrospective	Italy	5	Not assessed	57	Not assessed	128

SG: Sleeve gastrectomy; OAGB: One-anastomosis gastric bypass; BMI: Body mass index.

Table 2 Operation time, hospital stay, quality of life, and mortality in one-anastomosis gastric bypass and sleeve gastrectomy

Ref.	Operation time, SG	Operation time, OAGB	Hospital stay, SG	Hospital stay, OAGB	Quality of life, SG	Quality of life, OAGB	Mortality, SG	Mortality, OAGB
Abouelela et al[23], 2020	69.11 ± 15.89	82.89 ± 22.89	1.87 ± 0.5	1.56 ± 0.5	Not assessed	Not assessed	Not assessed	Not assessed
Bhandari et al[24], 2019	36.12 ± 10.55	55.96 ± 25.55	Not assessed	Not assessed	Not assessed	Not assessed	1	0
Das et al[25], 2024	110.6 ± 36.5	139.7 ± 62.1	2.42 ± 1.84	2.58 ± 1.61	Not assessed	Not assessed	Not assessed	Not assessed
Jammu and Sharma[26], 2016	60 ± 7.5	57.5 ± 8.25	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed
Kular et al[28], 2014	76.6 ± 28.3	52 ± 20.2	3.4 ± 2.4	2.5 ± 1.3	Not assessed	Not assessed	Not assessed	Not assessed
Lee et al[29], 2015	113.5 ± 31.1	117.2 ± 33.3	3.0 ± 1.7	3.4 ± 2.4	114.7 ± 14.7	109.8 ± 17.6	Not assessed	Not assessed
Madhok et al[31], 2016	75 ± 50.5	92 ± 31.5	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed
Plamper et al[33], 2017	112.1 ± 33.5	81.7 ± 25.3	7.2 ± 5.5	4.5 ± 2.6	Not assessed	Not assessed	Not assessed	Not assessed
Plamper et al[34], 2023	94 ± 31	77 ± 19	7 ± 13	4 ± 3	Not assessed	Not assessed	Not assessed	Not assessed
Poljo et al[35], 2021	66.5 ± 25.3	99.0 ± 31.5	Not assessed	Not assessed	1.0 ± 0.4	1.0 ± 0.7	Not assessed	Not assessed
Rajan et al[36], 2020	103.5 ± 31.1	116.2 ± 32.3	3.1 ± 0.3	4.0 ± 0.0	Not assessed	Not assessed	1	0
Schmitz et al[38], 2022	92.10 ± 3.1	81.36 ± 1.6	4.53 ± 0.2	3.44 ± 0.1	Not assessed	Not assessed	Not assessed	Not assessed
Seetharamaiah et al[46], 2017	44.8 ± 10.6	64.8 ± 10.6	3.95 ± 0.73	3.2 ± 0.64	Not assessed	Not assessed	Not assessed	Not assessed
Shivakumar et al[47], 2018	44.8110.62	44.81 ± 10.62	3.95 ± 0.73	3.2 ± 0.64	Not assessed	Not assessed	Not assessed	Not assessed
Jain et al[48], 2021	Not assessed	Not assessed	Not assessed	Not assessed	1.86 ± 0.56	2.35 ± 0.41	Not assessed	Not assessed
Litmanovich et al[30], 2025	Not assessed	Not assessed	4.1 ± 1.8	3.6 ± 2.4	Not assessed	Not assessed	1	0
Singla et al[41], 2024	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed	2	0
Tasdighi et al[43], 2022	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed	Not assessed	8	0
Alkhalifah et al[45], 2018	115.2 ± 35.7	124.6 ± 38.8	3.1 ± 3.1	5.0 ± 4.1	Not assessed	Not assessed	Not assessed	Not assessed

SG: Sleeve gastrectomy; OAGB: One-anastomosis gastric bypass.

Table 3 Complications, super obesity, diabetes status, gastroesophageal reflux disease, and malnutrition in one-anastomosis gastric bypass and sleeve gastrectomy

Ref.	Superobese, OAGB	Superobese, SG	Diabetes, OAGB, %	Diabetes, SG, %	Acute complications	Chronic complications	GORD/OAGB	GORD/SG	Malnutrition/OAGB	Malnutrition/SG
Abouelela et al[23], 2020	Yes	Yes	48	56	Yes	N. A	N. A	N. A	N. A	N. A
Bhandari et al[24], 2019	Yes	Yes	22.6	22.6	Yes	N. A	N. A	N. A	N. A	N. A
Das et al[25], 2024	No	Yes	21.1	19.2	Yes	N. A	5	9	N. A	N. A
Jammu and Sharma[26], 2016	No	No	17.4	2.7	Yes	N. A	3	32	41/473	12/339
Jung et al[27], 2022	No	No	N. A	N. A	Overall	N. A	N. A	N. A	N. A	N. A
Kular et al[28], 2014	N. A	N. A	N. A	N. A	5 vs 14	14 vs 26	2	16	6/72	2/76
Lee et al[29], 2015	No	No	N. A	N. A	Yes	N. A	N. A	N. A	N. A	N. A
Litmanovich et al[30], 2025	Yes	Yes	35.6	39.5	N. A	Yes	11	23	7/39	14/55
Madhok et al[31], 2016	Yes	Yes	31.5	30.3	0 vs 3	2 vs 5	1	5	N. A	N. A
Musella et al[32], 2014	No	No	22.9	22.9	8 vs 5	3 vs 20	N. A	N. A	11/175	4/80
Plamper et al[33], 2017	Yes	Yes	35	40.7	Yes	N. A	N. A	N. A	N. A	N. A
Plamper et al[34], 2023	Yes	Yes	78.8	55	41 vs 14	394 vs 142	76	43	182/911	29/241
Poljo et al[35], 2021	No	No	72.7	64	3 vs 1	0 vs 3	N. A	N. A	N. A	N. A
Rajan et al[36], 2020	Yes	Yes	N. A	N. A	Yes	N. A	N. A	N. A	N. A	N. A
Roushdy et al[37], 2020	No	No	N. A	N. A	Yes	N. A	N. A	N. A	N. A	N. A
Schmitz et al[38], 2022	Yes	Yes	34	45.7	N. A	69 vs 53	9	10	32/150	14/93
Singhal et al[39], 2022	No	No	33	16	Yes	N. A	N. A	N. A	N. A	N. A
Singla et al[40], 2019	No	No	85.7	77.8	N. A	Yes	N. A	N. A	N. A	N. A
Singla et al[41], 2024	Yes	Yes	N. A	N. A	N. A	Yes	N. A	N. A	N. A	N. A
Soong et al[42], 2021	Yes	Yes	N. A	N. A	Yes	N. A	N. A	N. A	17/246	5/190
Tasdighi et al[43], 2022	Yes	Yes	N. A	N. A	N. A	Yes	N. A	N. A	N. A	N. A
Vrakopoulou et al[44], 2021	Yes	Yes	100	100	Yes	N. A	N. A	N. A	N. A	N. A
Alkhalifah et al[45], 2018	No	No	30.8	18.5	Yes	N. A	0	31	43/1731	0/1107
Seetharamaiah et al[46], 2017	No	No	48	49	Yes	N. A	2	3	N. A	N. A
Shivakumar et al[47], 2018	No	No	48	49	Yes	N. A	N. A	N. A	N. A	N. A
Jain et al[48], 2021	Yes	Yes	47	49	N. A	N. A	3	4	13/101	7/100
Musella et al[49], 2021	No	No	N. A	N. A	N. A	N. A	31	28	N. A	N. A
Vitiello et al[50], 2023	No	No	N. A	N. A	N. A	N. A	25	15	N. A	N. A
Abu Sneineh et al[51], 2021	No	No	N. A	N. A	N. A	N. A	30/98	39/42	N. A	N. A
Genco et al[52], 2021	No	No	N. A	N. A	N. A	N. A	12/48	33/95	N. A	N. A
Gambardella et al[53], 2024	No	No	N. A	N. A	N. A	N. A	N. A	N. A	5/57	5/128

N. A: Not assessed; SG: Sleeve gastrectomy; OAGB: One-anastomosis gastric bypass; GORD: Gastroesophageal reflux.

Table 4 Newcastle-Ottawa scale risk of bias assessment tool

Ref.	Selection	Comparability	Outcome	Total score
Abouelela et al[23], 2020	3	1	2	6
Bhandari et al[24], 2019	2	1	2	5
Das et al[25], 2024	4	2	2	8
Jammu and Sharma[26], 2016	4	2	2	8
Jung et al[27], 2022	3	2	2	7
Kular et al[28], 2014	3	2	2	8
Lee et al[29], 2015	4	2	2	8
Litmanovich et al[30], 2025	3	2	2	7
Madhok et al[31], 2016	3	1	2	6
Musella et al[32], 2014	4	2	2	8
Plamper et al[33], 2017	3	1	2	6
Plamper et al[34], 2023	3	2	2	7
Poljo et al[35], 2021	2	2	2	6
Rajan et al[36], 2020	2	1	2	5
Schmitz et al[38], 2022	2	1	2	5
Singhal et al[39], 2022	3	2	2	7
Singla et al[40], 2019	2	1	2	5
Singla et al[41], 2024	3	2	2	7
Soong et al[42], 2021	3	1	2	6
Tasdighi et al[43], 2022	3	1	3	7
Vrakopoulou et al[44], 2021	3	2	2	7
Alkhalifah et al[45], 2018	3	2	2	7
Musella et al[49], 2021	4	2	2	8
Abu Sneineh et al[51], 2021	3	2	2	7
Genco et al[52], 2021	3	2	2	7
Gambardella et al[53], 2024	4	2	2	8

Table 5 Risk of bias assessment of the included studies according to the Cochrane risk of bias of randomized controlled trials

Ref.	Selection bias1	Selection bias2	Performance bias	Attrition bias	Detection bias	Reporting bias	Overall bias
Roushdy et al[37], 2020	Low	Some concerns	Some concerns	Some concerns	Some concerns	Low	Some concerns
Seetharamaiah et al[46], 2017	Low	Some concerns	Some concerns	Some concerns	Some concerns	Low	Some concerns
Shivakumar et al[47], 2018	Low	Low	Some concerns	Some concerns	Low	Low	Low
Jain et al[48], 2021	Low	Low	High	Low	Some concern	Some concern	Some concerns
Vitiello et al[50], 2023	Low	Low	High	High	Low	Low	low

¹Random sequence generation.

²Allocation concealment.

Table 6 The effect of different studies on heterogeneity

Ref.	Effect on heterogeneity, complication rate	Effect on heterogeneity, operation time	Effect on heterogeneity, hospital stay
Abouelela et al[23], 2020	1% increase	No effect	No effect
Bhandari et al[24], 2019	No effect	1 decrease
Das et al[25], 2024	1% increase	No effect	No effect
Jammu and Sharma[26], 2016	1% increase	No effect
Jung et al[27], 2022	No effect
Kular et al[28], 2014	1% increase	No effect	No effect
Lee et al[29], 2015	1% increase	No effect	No effect
Litmanovich et al[30], 2025	1% increase		No effect
Madhok et al[31], 2016	1% increase	No effect
Musella et al[32], 2014	1% increase
Plamper et al[33], 2017	1% increase	No effect	No effect
Plamper et al[34], 2023	No effect	No effect	No effect
Poljo et al[35], 2021	1% increase	No effect
Rajan et al[36], 2020	1% increase	No effect	No effect
Roushdy et al[37], 2020	1% increase
Schmitz et al[38], 2022	1% increase	1% decrease	1% decrease
Singhal et al[39], 2022	2% decrease
Singla et al[40], 2019	1% increase
Singla et al[41], 2024	No effect
Soong et al[42], 2021	No effect
Tasdighi et al[43], 2022	12% decrease
Vrakopoulou et al[44], 2021	1% increase
Alkhalifah et al[45], 2018		1% decrease	3% decrease
Seetharamaiah et al[46], 2017		No effect	No effect
Shivakumar et al[47], 2018		No effect	No effect
Jain et al[48], 2021