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Indications and Long-Term Outcomes of Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass

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Abstract

Purpose

Long-term results on sleeve gastrectomy (SG) with more than 10 years report patients needing sleeve revision for weight loss failure, de novo gastroesophageal reflux (GERD), or sleeve complications. The aim of this study was to analyze the results of laparoscopic conversion of failed SG to Roux-en-Y gastric bypass (RYGB).

Materials and Methods

Retrospective review of a prospectively institutional maintained database to identify patients who underwent conversion of SG to RYGB between 2012 and June 2020.

Results

Sixty patients(50 females) underwent conversion to RYGB. Average time to conversion was 5.6 years (2–11). Mean %WL and TWL after SG were respectively 26±8.8% and 33.2±14.1kg. Mean BMI at the time of RYGB was 38.1±7.1 kg/m2. Mean follow-up was 30.4±16.8 months (6–84). Available patients at each time of follow-up: 1 year 59 (98.3%); 2 years 47 (78.3%); 3 years 39 (71.6%); and 5 years 33 (55%). Patients were divided according to indication for revision in weight regain/insufficient weight loss (30 patients) group 1 and GERD/complications (25 patients) group 2. Percentage of excess weight loss at 1, 3, and 5 years follow-up after bypass was for group 1 40.3±17.6, 34.3±19.5, and 23.2±19.4 and for group 2 90.4±37, 62.6±28.2, and 56±35.02. Total weight loss at last follow-up since sleeve was respectively 31kg in group 1 and 46.7kg in group 2 (p=0.002). No mortality was observed. Thirty-day complication rate was 3.3%.

Conclusion

RYGB after SG is a safe and effective revisional procedure to manage weight regain and de novo GERD, to address complications, and to improve comorbidities.

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Authors and Affiliations

  1. Department of Digestive and Endocrine Surgery, University Hospital of Strasbourg, Research Institute Against Digestive Cancer (IRCAD), Institute of Image-Guided Surgery (IHU), 1 place de l’Hôpital, 67000, Strasbourg, France

    Antonio D’Urso, Michel Vix, Silvana Perretta, Mihaela Ignat, Louise Scheer & Didier Mutter

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Correspondence to Antonio D’Urso.

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Keypoints

Sleeve revision, revisional gastric bypass, weight failure, sleeve complication

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D’Urso, A., Vix, M., Perretta, S. et al. Indications and Long-Term Outcomes of Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass. OBES SURG 31, 3410–3418 (2021). https://doi.org/10.1007/s11695-021-05444-4

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