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Reoperative bariatric surgery after primary laparoscopic gastric plication for morbid obesity: a systematic review and meta-analysis

  • Systematic Reviews and Meta-analyses
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Abstract

Background

Laparoscopic gastric plication (LGP) often requires reoperative bariatric surgery (RBS) due to complications and insufficient weight loss. The aim of our study was to assess perioperative morbidity and weight loss during follow-up in patients undergoing RBS after primary LGP for morbid obesity.

Methods

A search of PubMed, Web of Science, Cochrane Library, and Google Scholar was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using (“conversion”OR “revision*”"OR “reoperat*”)AND(“gastric”OR “curvatur*”)AND “plication.” Studies were deemed eligible if data on RBS after LGP were provided. For each study, data were extracted and analyzed.

Results

In the literature review, 291 articles were screened and 7 included. The studies covered a total of 367 patients, of whom 119 received a sleeve gastrectomy (SG), 85 a Roux-en-y gastric bypass (RYGB), 75 a one anastomosis-gastric bypass (OAGB), 45 a re-LGP, and 25 a jejuno-ileal bypass. After RBS, excess weight loss was 50.8 ± 6.5% at 6 months, 71.0 ± 7.7% at 12 months, and 89.0 ± 7.8% at 24 months. Operative time was 101.3 ± 14.6 min. Postoperatively, 18/255 patients (7.1%) had a complication, and leakage and reoperations were reported in 6/255 (2.4%) and 5/255 (2.0%) patients, respectively. Length of hospital stay was 3.1 ± 2.4 days. The quality of evidence was rated as “very low.”

Conclusions

Despite limitations, this systematic review and meta-analysis showed that RBS after LGP has an acceptable rate of complications and is effective in terms of excess weight loss during follow-up. No specific operation (e.g., SG, RYGB, OAGB) can be suggested over another due to the lack of evidence.

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Author notes

  1. Francesco Mongelli and Zsofia Horvath contributed equally to the work.

Authors and Affiliations

  1. Department of Surgery, Lugano Regional Hospital, EOC, Via Tesserete, 6900, Lugano, Switzerland

    Francesco Mongelli, Zsofia Horvath & Fabio Garofalo

  2. Department of Surgery, Locarno Regional Hospital, EOC, Via Dell’Ospedale, 6600, Locarno, Switzerland

    Michele Marengo

  3. Department of Surgery, Sant’Anna Clinic, Via Sant’Anna 1, 6924, Lugano, Switzerland

    Francesco Volontè

  4. Department of Surgery, Bellinzona e Valli Regional Hospital, EOC, Via Ospedale, 6500, Bellinzona, Switzerland

    Davide La Regina

  5. Department of Visceral Surgery, Clarunis - University Center for Gastrointestinal and Liver Disesases, 4031, Basel, Switzerland

    Ralph Peterli

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  1. Francesco Mongelli
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Contributions

Study conception and design: FM, ZH, MM, DLR, FG. Acquisition of data: ZH, FM, FV, RP. Analysis and interpretation of data: FM, MM, RP, FG. Drafting of manuscript: ZH, MM, FV, DLR. Critical revision of manuscript: FM, RP, FG.

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Correspondence to Francesco Mongelli.

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Mongelli, F., Horvath, Z., Marengo, M. et al. Reoperative bariatric surgery after primary laparoscopic gastric plication for morbid obesity: a systematic review and meta-analysis. Langenbecks Arch Surg 407, 1839–1850 (2022). https://doi.org/10.1007/s00423-022-02485-w

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