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Obesity Surgery

, Volume 23, Issue 11, pp 1766–1773 | Cite as

Revisional Bariatric Surgery for Unsuccessful Weight Loss and Complications

  • Hideharu Shimizu
  • Shohrat Annaberdyev
  • Isaac Motamarry
  • Matthew Kroh
  • Philip R. Schauer
  • Stacy A. BrethauerEmail author
Original Contributions

Abstract

Background

There are growing numbers of patients who require revisional bariatric surgery due to the undesirable results of their primary procedures. The aim of this study was to review our experience with bariatric patients undergoing revisional surgery.

Methods

We conducted a retrospective analysis to review the indications for revisional bariatric procedures and assess their postoperative outcomes.

Results

From 04/04 to 01/11, 2,918 patients underwent bariatric surgery at our institution. A total of 154 patients (5.3 %) of these cases were coded as revisional procedures. The mean age at revision was 49.1 ± 11.3 and the mean BMI was 44.0 ± 13.7 kg/m2. Revisional surgery was performed laparoscopically in 121 patients (78.6 %). Laparoscopic revisions had less blood loss, shorter length of hospital stay, and fewer complications compared to open revisions. Two groups (A and B) were defined by the indication for revision: patients with unsuccessful weight loss (group A, n = 106) and patients with complications of their primary procedures (group B, n = 48). In group A, 74.5 % of the patients were revised to a bypass procedure and 25.5 % to a restrictive procedure. Mean excess weight loss was 53.7 ± 29.3 % after revision of primary restrictive procedures and 37.6 ± 35.1 % after revision of bypass procedures at >1-year follow-up (p < 0.05). In group B, the complications prompting revision were effectively treated by revisional surgery.

Conclusions

Revisional bariatric surgery effectively treated the undesirable results from primary bariatric surgery. Laparoscopic revisional surgery can be performed after both failed open and laparoscopic bariatric procedures without a prohibitive complication rate. Carefully selected patients undergoing revision for weight regain have satisfactory additional weight loss.

Keywords

Bariatric surgery Morbid obesity Gastric bypass Laparoscopic Reoperative surgery 

Notes

Disclosures

The authors declare that they have no conflicts of interest in this study.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Hideharu Shimizu
    • 1
  • Shohrat Annaberdyev
    • 1
  • Isaac Motamarry
    • 1
  • Matthew Kroh
    • 1
  • Philip R. Schauer
    • 1
  • Stacy A. Brethauer
    • 1
    Email author
  1. 1.Bariatric and Metabolic InstituteCleveland ClinicClevelandUSA

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