Medium-Term Outcomes from a Series of 1000 One Anastomosis Gastric Bypass in Australia: A Case Series

PURPOSE

This study presents the short- (less than 6 months) and medium-term (6 months to 2 years) outcomes for weight loss and type 2 diabetes mellitus (T2DM) for all patients undergoing one anastomosis gastric bypass (OAGB) across multiple institutions between 2015 and 2021.

MATERIALS AND METHODS

A retrospective analysis of prospectively collected databases was performed including 1022 participants who underwent OAGB at multiple institutions by multiple surgeons between 2015 and 2021. Primary outcome was percentage total weight loss (TWL) and secondary outcomes were achieving resolution of T2DM; OAGB specific short- and medium-term complications including bile reflux, marginal ulceration and internal herniation.

RESULTS

One thousand and twenty-two patients underwent OAGB (81% primary surgery). A percentage of 34.1% (n = 349) had a preoperative diagnosis of type 2 diabetes mellitus (T2DM). Mean TWL was 33.6 ± 9%  with a T2DM remission rate of 74% at 1-year post-op. Rates of bile reflux and marginal ulceration was 1.1% (n = 11) and 1.1% (n = 11). There were no cases of internal herniation during the follow-up period.

CONCLUSION

OAGB results has echoed previously published work as being efficacious and safe in a short-medium term. The prevalence of complications, especially bile reflux is overall low in our population and no current evidence exists to support an increased risk of metaplasia or malignancy related to bile within the stomach.

Hepatitis C direct-acting antiviral treatment completion: Comparison of geographic, demographic and clinical characteristics in Australia

BACKGROUND AND OBJECTIVES

Hepatitis C virus treatment uptake varies by geographic area in Australia; however, analysis has not been conducted on variations in treatment completion. This study investigated treatment completion according to remoteness, as well as demographic and clinical characteristics.

METHOD

A retrospective analysis was conducted on all Pharmaceutical Benefits Scheme claim data from March 2016 to June 2019. Treatment was considered completed if all prescriptions required to complete the course were dispensed. Treatment completion was compared by remoteness of residence, sex, age, state or territory, treatment duration and prescriber type.

RESULTS

Of 68,940 patients, 85.6% completed treatment, although the completion rate decreased over time. Residents living in very remote areas had the lowest treatment completion rate (74.3%; odds ratio [OR] 0.52; 95% confidence interval [CI]: 0.39, 0.7; P < 0.005), particularly those treated by general practitioners (GPs; 66.7%; OR 0.47; 95% CI: 0.22, 0.97; P = 0.042).

DISCUSSION

This analysis suggests that people in very remote areas of Australia have the lowest hepatitis C treatment completion rate, particularly those accessing treatment through GPs. Further investigation into predictors of low treatment completion within these populations is required.