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Obesity Surgery

, Volume 28, Issue 9, pp 2903–2911 | Cite as

Revisional But Not Conversional Gastric Bypass Surgery Increases the Risk of Leaks: Review of 176 Redo out of 932 Consecutive Cases

  • Marine Benois
  • Lionel Sebastianelli
  • Adeline Morisot
  • Imed Ben Amor
  • Jean Gugenheim
  • Laurent Bailly
  • Antonio IannelliEmail author
Original Contributions
  • 140 Downloads

Abstract

Introduction

Nowadays, surgeons are dealing more and more with patients experiencing failure of a previous bariatric procedure after the worldwide exponential increase of bariatric surgery. Only a few and contradictory studies investigated both outcomes and complications risk factors in this subset population of bariatric patients. We aimed to study a homogeneous population of patients undergoing redo bariatric surgery (REDO-BS) resulting in bypass anatomy to evaluate early postoperative outcomes and identify risk factors of postoperative complications and mortality.

Material and Methods

In this study, we compared the outcomes of patients undergoing REDO-BS from another former bariatric procedure into Roux-en-Y gastric bypass (RYGP) to those undergoing primary RYGP. Data were extracted from a prospectively maintained database.

Results

One hundred thirty-eight conversional bariatric surgery (CBS) cases resulting in RYGP anatomy and 38 RBS cases of pouch resizing (PR) were compared with 756 primary RYGP. There were no statistical significant difference in outcomes between the primary and CBS groups but patients undergoing PR had a significant higher risk of developing a leak than others. CBS complication risk factors were age (OR = 1.05; p = 0.04), operative time, and T2DM (OR = 4.11; p = 0.03).

Conclusions

CBS is safe and leads to similar early postoperative outcomes as primary RYGP whereas the indication for revisional surgery such as PR should be carefully evaluated as it is associated with an increased risk of leak.

Keywords

Bariatric surgery Redo surgery Conversion Roux-en-Y gastric bypass Sleeve gastrectomy Pouch resizing Complications 

Notes

Compliance with Ethical Standards

For this type of retrospective study, formal consent was not required.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent Statement

Does not apply.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Marine Benois
    • 1
  • Lionel Sebastianelli
    • 1
  • Adeline Morisot
    • 2
  • Imed Ben Amor
    • 1
  • Jean Gugenheim
    • 1
  • Laurent Bailly
    • 2
  • Antonio Iannelli
    • 1
    • 3
    • 4
    • 5
    Email author
  1. 1.Digestive Unit, Archet 2 HospitalUniversity Hospital of NiceNiceFrance
  2. 2.Department of Public HealthUniversity Hospital of NiceNiceFrance
  3. 3.Inserm, U1065, Team 8 “Hepatic Complications of Obesity”NiceFrance
  4. 4.University of Nice Sophia-AntipolisNiceFrance
  5. 5.Service de Chirurgie Digestive et Centre de Transplantation HépatiqueHôpital Archet 2Nice Cedex3France

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