Weight Regain After Gastric Plication: Reoperative Sleeve Gastrectomy or Roux-en-Y Gastric Bypass?—Analysis of 116 Consecutive Cases

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A Correction to this article was published on 26 June 2020

This article has been updated

Abstract

Purpose

In France, laparoscopic gastric plication (GP) has rarely been utilized as a weight loss procedure. Although relatively safe and efficient, its long-term results are still controversial. The goal of this study is to assess the indications and outcomes of revisional surgery post-GP.

Materials and Methods

Between February 2010 and September 2017, patient characteristics undergoing GP were prospectively collected from our database. Failure of conservative treatment or presence of anatomical anomaly explaining weight loss insufficiency was an indication for revisional surgery (RS).

Results

A total of 300 patients were included, 41 patients were lost to follow-up (13.7%), 124 patients (41.3%) had total weight loss (TWL) > 30%, and 116 patients (38.7%) underwent RS. Revisional procedures were laparoscopic Roux-en-Y gastric bypass (RYGB) in 72 patients (62.1%) and sleeve gastrectomy (SG) in 44 patients (37.9%). The median interval to RS was 29 months. The mean operative time was 60 min for the SG and 125 min for the RYGB (p < 0.0001). Mortality was nil. Significant morbidity occurred in eight patients (6.9%) including 4 non-abdominal complications, 1 gastric leak, 1 case of hemorrhage, 1 case of hematoma, and 1 intra-abdominal abscess. The mean length of hospital stay (LOS) was 2.9 days (range, 1–11) for the SG group vs 3.2 days (range, 2–8) for the RYGB group (p = 0.608).

Conclusion

GP is associated with a relatively high rate of weight regain or insufficient weight loss. When compared to SG, RYGB seems to be the safer revisional procedure with fewer surgical complications.

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Fig. 1

Change history

  • 26 June 2020

    In the original article the name of author Luigi Prisco was incorrect. It is correct here.

References

  1. 1.

    Popkin BM. The nutrition transition: an overview of world patterns of change. Nutr Rev. 2004;62(7 Pt 2):S140–3.

    Article  Google Scholar 

  2. 2.

    Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;12:557–67.

    Article  Google Scholar 

  3. 3.

    Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31:1248–61.

    CAS  Article  Google Scholar 

  4. 4.

    Dixon JB, Strauss BJ, Laurie C, et al. Changes in body composition with weight loss: obese subjects randomized to surgical and medical programs. Obesity. 2007;15:1187–98.

    Article  Google Scholar 

  5. 5.

    Debs T, Petrucciani N, Kassir R, et al. Trends of bariatric surgery in France during the last 10 years: analysis of 267,466 procedures from 2005–2014. Surg Obes Relat Dis. 2016;12(8):1602–9.

    Article  Google Scholar 

  6. 6.

    Aurora AR, Khaitan L, Saber AA. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients. Surg Endosc. 2008;26:1509–15.

    Article  Google Scholar 

  7. 7.

    Nocca D, Frering V, Gallix B, et al. Migration of adjustable gastric banding from a cohort study of 4236 patients. Surg Endosc. 2005;19:947–50.

    CAS  Article  Google Scholar 

  8. 8.

    Baltasar A, Bou R, Bengochea M, et al. Use of a Roux limb to correct esophagogastric junction fistulas after sleeve gastrectomy. Obes Surg. 2007;17:1408–10.

    Article  Google Scholar 

  9. 9.

    Chouillard E, Chahine E, Schoucair N, et al. Roux-en-Y fistulo-jejunostomy as a salvage procedure in patients with post-sleeve gastrectomy fistula. Surg Endosc. 2014;28:1954–60.

    Article  Google Scholar 

  10. 10.

    Talebpour M, Amoli BS. Laparoscopic total gastric vertical plication in morbid obesity. J Laparoendosc Adv Surg Tech A. 2007;17:793–8.

    Article  Google Scholar 

  11. 11.

    Broderick RC, Fuchs HF, Harnsberger CR, et al. Comparison of bariatric restrictive operations: laparoscopic sleeve gastrectomy and laparoscopic gastric greater curvature plication. Surg Technol Int. 2014;25:82–9.

    PubMed  Google Scholar 

  12. 12.

    Ji Y, Wang Y, Zhu J, et al. A systematic review of gastric plication for the treatment of obesity. Surg Obes Relat Dis. 2014;10:1226–32.

    Article  Google Scholar 

  13. 13.

    Chouillard E. Gastric plication, sleeve killer? Obésité. 2011;6:253–5.

    Article  Google Scholar 

  14. 14.

    Hatoum IJ, Kaplan LM. Advantages of percent weight loss as a method of reporting weight loss after Roux en Y gastric bypass. Obesity (Silver Spring). 2013;21:1519–25.

    Article  Google Scholar 

  15. 15.

    Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  Google Scholar 

  16. 16.

    Tretbar LL, Taylor TL, Sifers EG. Weight reduction. Gastric plication for morbid obesity. J Kans Med Soc. 1976;77:488–90.

    CAS  PubMed  Google Scholar 

  17. 17.

    Clinical Issues Committee. ASMBS policy statement on gastric plication. Surg Obes Relat Dis. 2011;7:262.

    Article  Google Scholar 

  18. 18.

    Dargent J, Vilallonga R, Katz L, et al. IFSO position statement on new technologies for treatment of obesity: the International Federation for Surgery of Obesity (IFSO) and its new technologies committee. Endorsed by the ethical committee of IFSO, approved by the IFSO Executive Council on May, 3, 2017. Obes Surg. 2017;27(9):2456–9.

    Article  Google Scholar 

  19. 19.

    Talebpour M, Sadid D, Talebpour A, et al. Comparison of short-term effectiveness and postoperative complications: laparoscopic gastric plication vs laparoscopic sleeve gastrectomy. Obes Surg. 2018;28(4):996–1001.

    Article  Google Scholar 

  20. 20.

    Doležalova-Kormanova K, Buchwald JN, Skochova D, et al. Five-year outcomes: laparoscopic greater curvature plication for treatment of morbid obesity. Obes Surg. 2017;27(11):2818–28.

    Article  Google Scholar 

  21. 21.

    Ye Q, Chen Y, Zhan X, et al. Comparison of laparoscopic sleeve gastrectomy and laparoscopic greater curvature plication regarding efficacy and safety: a meta-analysis. Obes Surg. 2017;27(5):1358–64.

    Article  Google Scholar 

  22. 22.

    Chouillard E, Schoucair N, Alsabah S, et al. Laparoscopic gastric plication (LGP) as an alternative to laparoscopic sleeve gastrectomy (LSG) in patients with morbid obesity: a preliminary, short-term, case-control study. Obes Surg. 2016;26(6):1167–72.

    Article  Google Scholar 

  23. 23.

    Ji Y, Wang Y, Zhu J, et al. A systematic review of gastric plication for the treatment of obesity. Surg Obes Relat Dis. 2014;10(6):1226–32.

    Article  Google Scholar 

  24. 24.

    Brethauer SA, Kothari S, Sudan R, et al. Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis. 2014;10(5):952–72.

    Article  Google Scholar 

  25. 25.

    Zerrweck C, Rodríguez JG, Aramburo E, et al. Revisional surgery following laparoscopic gastric plication. Obes Surg. 2017;27(1):38–43.

    Article  Google Scholar 

  26. 26.

    Albanese A, Prevedello L, Verdi D, et al. Laparoscopic gastric plication: an emerging bariatric procedure with high surgical revision rate. Bariatr Surg Pract Patient Care. 2015;10(3):93–8.

    Article  Google Scholar 

  27. 27.

    Talebpour M, Motamedi SMK, Talebpour A, et al. Twelve year experience of laparoscopic gastric plication in morbid obesity: development of the technique and patient outcomes. Ann Surg Innov Res. 2012;6(1):7.

    Article  Google Scholar 

  28. 28.

    Hallowell PT, Stellato TA, Yao DA, et al. Should bariatric revisional surgery be avoided secondary to increased morbidity and mortality? Am J Surg. 2009;197(3):391–6.

    Article  Google Scholar 

  29. 29.

    Atlas H, Yazbek T, Garneau PY, et al. Is there a future for laparoscopic gastric greater curvature plication (LGGCP)? A review of 44 patients. Obes Surg. 2013;23:1397–403.

    Article  Google Scholar 

  30. 30.

    Heidari R, Talebpour M, Soleyman-Jahi S, et al. Outcomes of reoperation after laparoscopic gastric plication failure. Obes Surg. 2019;29(2):376–86.

    Article  Google Scholar 

  31. 31.

    Yavuz E, Aktokmakyan TV, Osman Bilgin Gulcicek OG, et al. Revisional surgery after gastric plication: replication or sleeve? Bariatric Surg Pract Patient Care. 2019;14(1):7–11.

    Article  Google Scholar 

  32. 32.

    Moon RC, Teixeira AF, Jawad MA. Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass? Surg Obes Relat Dis. 2013;9(6):901–7.

    Article  Google Scholar 

  33. 33.

    Antonopulos C, Rebibo L, Calabrese D, et al. Comparison of repeat sleeve gastrectomy and Roux-en-Y gastric bypass in case of weight loss failure after sleeve gastrectomy. Obes Surg. 2019;29(12):3919–27.

    Article  Google Scholar 

  34. 34.

    Nesset EM, Kendrick ML, Houghton SG, et al. A two-decade spectrum of revisional bariatric surgery at a tertiary referral center. Surg Obes Relat Dis. 2007;3(1):25–30.

    Article  Google Scholar 

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Correspondence to Elias Chahine.

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Chahine, E., Alkandari, M., De Simone, B. et al. Weight Regain After Gastric Plication: Reoperative Sleeve Gastrectomy or Roux-en-Y Gastric Bypass?—Analysis of 116 Consecutive Cases. OBES SURG 30, 3982–3987 (2020). https://doi.org/10.1007/s11695-020-04767-y

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Keywords

  • Obesity surgery
  • Laparoscopic gastric bypass
  • Laparoscopic gastric plication
  • Laparoscopic sleeve gastrectomy
  • Revisional surgery
  • Greater curvature plication
  • Surgical failure