Obesity Surgery

, Volume 24, Issue 8, pp 1386–1390

Midterm Outcomes of Revisional Surgery for Gastric Pouch and Gastrojejunal Anastomotic Enlargement in Patients with Weight Regain After Gastric Bypass for Morbid Obesity

Authors

  • Abdulrahman Hamdi
    • Howard University Hospital
  • Christopher Julien
    • Howard University Hospital
  • Phillip Brown
    • Howard University Hospital
  • Ian Woods
    • Howard University Hospital
  • Anas Hamdi
    • Howard University Hospital
  • Gezzer Ortega
    • Howard University Hospital
  • Terrence Fullum
    • Howard University Hospital
    • Howard University Hospital
Original Contributions

DOI: 10.1007/s11695-014-1216-z

Cite this article as:
Hamdi, A., Julien, C., Brown, P. et al. OBES SURG (2014) 24: 1386. doi:10.1007/s11695-014-1216-z

Abstract

Reoperative surgery for the morbidly obese has become increasingly common due to postoperative weight regain. There are limited studies evaluating the effectiveness of revisional surgery. This study evaluates the weight loss outcomes of revisional surgery over a 2-year period at our University Hospital, USA. Of the 412 patients who underwent laparoscopic bariatric surgery between June 2009 and June 2011, we identified 25 patients who had Roux-en-Y gastric bypass (RYGB) originally, who underwent laparoscopic revisional surgery for weight regain. Preoperative and postoperative data were reviewed. Statistical analysis was performed using paired t test. This study includes 0 male and 25 female patients with an average age of 42 (range min to max: 28–58), mean original body mass index (BMI) of 54.6 kg/m2 (r = 37.3–80.7), average lowest BMI achieved of 32.2 (r = 20.1–50.9), and average BMI at the time of revision of 41.0 kg/m2 (r = 29.5–60.7, standard deviation (SD) = 8.5). All laparoscopic revisions consisted of resizing the gastric pouch by resection and recreating the gastrojejunostomy. Average hospital length of stay was 1.28 days (r = 1–4). Perioperative morbidity was 8 %; one patient developed a trocar site hernia which required repair, and another suffered postoperative bleeding requiring transfusion. There was no mortality. Postoperative BMI averages at 3, 6, 9, 12, and 24 months were 35.0 (SD = 7.15), 34.7 (SD = 4.26), 36.2 (SD = 7.63), 33.0 (SD = 6.58), and 44.2 (SD = 12.87), respectively. Statistically significant weight loss was achieved at 3 [t (10) = 6.74, p < 0.05], 6 [t (7) = 4.69, p < 0.05], 9 [t (9) = 2.94, p < 0.05], and 12 [t (6) = 3.78, p < 0.05] months. However, there was no statistically significant weight loss at 24 months postoperatively [t (4) = −0.16, p > 0.05]. Laparoscopic revisional bariatric surgery can be performed with significant weight loss up to 1 year postoperatively. However, additional studies are required to evaluate longer-term success.

Keywords

Bariatric surgeryBariatric revisional surgeryLaparoscopic

Abbreviations

BMI

Body mass index

EWL

Excess weight loss

Kg

Kilograms

GJ

Gastrojejunostomy

RYGB

Roux-en-Y gastric bypass

HTN

Hypertension

DM

Diabetes mellitus

GERD

Gastroesophageal reflux disease

Copyright information

© Springer Science+Business Media New York 2014