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Surgical Endoscopy

, Volume 27, Issue 11, pp 4277–4283 | Cite as

Sleeve gastrectomy or gastric bypass as revisional bariatric procedures: retrospective evaluation of outcomes

  • Mousa Khoursheed
  • Ibtisam Al-Bader
  • Ali Mouzannar
  • Abdulla Al-Haddad
  • Ali Sayed
  • Ali Mohammad
  • Abe Fingerhut
Article

Abstract

Background

A considerable number of patients require revisional surgery after laparoscopic adjustable gastric banding (LAGB). Studies that compared the outcomes of revisional sleeve gastrectomy (r-SG) and revisional Roux-en-Y gastric bypass (r-RYGB) after failed LAGB are scarce in the literature. Our objective was to determine whether significant differences exist in outcomes between r-SG and r-RYGB after failed LAGB.

Methods

From 2005 to 2012, patients who underwent laparoscopic r-SG and r-RYGB after failed LAGB were retrospectively compared and analyzed. Data included demographics, indication for revision, operative time, hospital stay, conversion rate, percentage excess weight loss (%EWL), and morbidity and mortality.

Results

Out of 693 bariatric procedures, 42 r-SG and 53 r-RYGB were performed. The median preoperative weight (107.7 and 117.7 kg, respectively, p = 0.02) and body mass index (BMI) (38.5 vs. 43.2 kg/m2, respectively, p = 0.01) were statistically significantly lower in r-SG than in r-RYGB. The mean operative time and median hospital stay were significantly shorter in r-SG than in r-RYGB (108.4 vs. 161.2 min, p < 0.01) (2 vs. 3 days, p = 0.02), respectively. One patient underwent conversion to open surgery after r-RYGB (p = 0.5). The reoperation rate was lower in r-SG than in r-RYGB (0.0 vs. 3.8 %, p = 0.5). There was one postoperative leak in the r-RYGB, and the overall complication rate was significantly lower in r-SG patients than in r-RYGB patients (7.1 vs. 20.8 %, p = 0.05). The mean follow-up was significantly shorter in the r-SG group (9.8 vs. 29.3 months, p < 0.01). However, the mean postoperative BMI was not different at 1 year (32.3 vs. 34.7, p = 0.29) as well as mean %EWL was (47.4 vs. 45.6 %, p = 0.77).

Conclusions

Both r-SG and r-RYGB are safe procedures with similar outcomes in terms of %EWL. As a result of the long-term potential nutritional complication of r-RYGB, r-SG may be a better option in this group of patients. Longer follow-up is needed.

Keywords

LAGB Revisional bariatric RYGB Sleeve 

Notes

Acknowledgments

The authors thank Dr. Joseph Longenecker for his help and support with the statistical analysis.

Disclosures

Dr. Mousa Khoursheed, Dr. Ibtisam Al-Bader I, Dr. Ali Mouzannar, Dr. Abdulla Al-Haddad, Dr. Ali Sayed, Dr. Ali Mohammad, and Dr. Abe Fingerhut have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Mousa Khoursheed
    • 1
  • Ibtisam Al-Bader
    • 1
  • Ali Mouzannar
    • 2
  • Abdulla Al-Haddad
    • 2
  • Ali Sayed
    • 2
  • Ali Mohammad
    • 2
  • Abe Fingerhut
    • 3
  1. 1.Department of Surgery, Faculty of MedicineKuwait UniversityJabriyaKuwait
  2. 2.Department of SurgeryMubarak Al-Kabeer HospitalJabriyaKuwait
  3. 3.First Department of SurgeryHippocration Hospital, University of Athens Medical SchoolAthensGreece

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