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Gastric Bypass pp 171-175 | Cite as

Conversion from Sleeve to Bypass

  • Alcides José Branco Filho
  • André Thá Nassif
Chapter
  • 38 Downloads

Abstract

It is estimated that at least approximately 10% of the sleeve gastrectomies (SG) present a therapeutic failure to the point of requiring revision surgery. Some longterm results shows higher rates up to 40 %. With the increase of bariatric surgery and proportionately of the SG, there is a tendency of the conversion from SG to Roux-en-Y gastric bypass (RYGB) to become one of the most common revisional surgeries. It is indicated mainly in cases of intractable gastroesophageal reflux and post-SG complications such as fistula and stenosis, but it has also been used for failure of weight loss and persistence of metabolic diseases. Technically it is a surgery similar to a primary RYGB with the gastric time and intestinal time but with the possible difficulties of a previous approach. For this reason it has a slightly higher rate of complications such as bleeding and fistulas but without increasing mortality. The conversion of SG to RYGB is considered a feasible, safe, and good technique between the options of revisional surgeries.

Keywords

Revisional surgery Sleeve to bypass Sleeve Sleeve failure Reflux Weight regain Sleeve complications Conversion to bypass Bypass 

References

  1. 1.
    Altieri MS, Yang J, Nie L, Blackstone R, Spaniolas K, Pryor A. Rate of revisions or conversion after bariatric surgery over 10 years in the state of New York. Surg Obes Relat Dis [Internet]. 2018;14(4):500–7.  https://doi.org/10.1016/j.soard.2017.12.019.CrossRefGoogle Scholar
  2. 2.
    Shimizu H, Annaberdyev S, Motamarry I, Kroh M, Schauer PR, Brethauer SA. Revisional bariatric surgery for unsuccessful weight loss and complications. Obes Surg. 2013;23(11):1766–73.CrossRefGoogle Scholar
  3. 3.
    Khoursheed MA, Al-Bader IA, Al-Asfar FS, Mohammad AI, Shukkur M, Dashti HM. Revision of failed bariatric procedures to Roux-en-Y gastric bypass (RYGB). Obes Surg. 2011;21(8):1157–60.CrossRefGoogle Scholar
  4. 4.
    El Chaar M, Stoltzfus J, Claros L, Miletics M. Indications for revisions following 630 consecutive laparoscopic sleeve gastrectomy cases: experience in a single accredited center. J Gastrointest Surg [Internet]. 2017;21(1):12–16. Available at:  https://doi.org/10.1007/s11605-016-3215-yCrossRefGoogle Scholar
  5. 5.
    Ferrer-Márquez M, Belda-Lozano R, Solvas-Salmerón J, Ferrer-Ayza M. Revisional surgery after laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2015;25(1):6–9.CrossRefGoogle Scholar
  6. 6.
    Deguines JB, Verhaeghe P, Yzet T, Robert B, Cosse C, Regimbeau JM. Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure? Surg Obes Relat Dis [Internet]. 2013;9(5):660–6.  https://doi.org/10.1016/j.soard.2012.11.010.CrossRefGoogle Scholar
  7. 7.
    Cheung D, Switzer NJ, Gill RS, Shi X, Karmali S. Revisional bariatric surgery following failed primary laparoscopic sleeve gastrectomy: a systematic review. Obes Surg. 2014;24(10):1757–63.CrossRefGoogle Scholar
  8. 8.
    Homan J, Betzel B, Aarts EO, Van Laarhoven KJHM, Janssen IMC, Berends FJ. Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis [Internet]. 2015;11(4):771–777. Available at:  https://doi.org/10.1016/j.soard.2014.09.029CrossRefGoogle Scholar
  9. 9.
    Sánchez-Pernaute A, Rubio MÁ, Conde M, Arrue E, Pérez-Aguirre E, Torres A. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis [Internet]. 2015;11(2):351–5.  https://doi.org/10.1016/j.soard.​2014.06.016.CrossRefGoogle Scholar
  10. 10.
    Ben AI, Debs T, Martini F, Elias B, Kassir R, Gugenheim J. Laparoscopic conversion of a sleeve gastrectomy to the Roux-en-Y gastric bypass. Obes Surg. 2015;25(8):1556–7.CrossRefGoogle Scholar
  11. 11.
    Abdemur A, Han SM, Lo Menzo E, Szomstein S, Rosenthal R. Reasons and outcomes of conversion of laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass for nonresponders. Surg Obes Relat Dis [Internet]. 2016;12(1):113–8.  https://doi.org/10.1016/j.soard.2015.04.005.CrossRefGoogle Scholar
  12. 12.
    Iannelli A, Debs T, Martini F, Benichou B, Ben Amor I, Gugenheim J. Laparoscopic conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: indications and preliminary results. Surg Obes Relat Dis [Internet]. 2016;12(8):1533–8.  https://doi.org/10.1016/j.soard.2016.04.008.CrossRefGoogle Scholar
  13. 13.
    Langer FB, Bohdjalian A, Shakeri-Leidenmühler S, Schoppmann SF, Zacherl J, Prager G. Conversion from sleeve gastrectomy to roux-en-y gastric bypass-indications and outcome. Obes Surg. 2010;20(7):835–40.CrossRefGoogle Scholar
  14. 14.
    Gautier T, Sarcher T, Contival N, Le Roux Y, Alves A. Indications and mid-term results of conversion from sleeve gastrectomy to roux-en-Y gastric bypass. Obes Surg. 2013;23(2):212–5.CrossRefGoogle Scholar
  15. 15.
    Carter PR, Leblanc KA, Hausmann MG, Kleinpeter KP, Debarros SN, Jones SM. Association between gastroesophageal reflux disease and laparoscopic sleeve gastrectomy. Surg Obes Relat Dis [Internet]. 2011;7(5):569–72.  https://doi.org/10.1016/j.soard.​2011.01.040.CrossRefGoogle Scholar
  16. 16.
    Soricelli E, Iossa A, Casella G, Abbatini F, Calì B, Basso N. Sleeve gastrectomy and crural repair in obese patients with gastroesophageal reflux disease and/or hiatal hernia. Surg Obes Relat Dis. 2013;9(3):356–62.CrossRefGoogle Scholar
  17. 17.
    Bohdjalian A, Langer FB, Shakeri-Leiden Mühler S, Gfrerer L, Ludvik B, Zacherl J, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.CrossRefGoogle Scholar
  18. 18.
    Nevo N, Abu-Abeid S, Lahat G, Klausner J, Eldar SM. Converting a sleeve gastrectomy to a gastric bypass for weight loss failure—is it worth it? Obes Surg. 2018;28(2):364–8.CrossRefGoogle Scholar
  19. 19.
    Cena H, De Giuseppe R, Biino G, Persico F, Ciliberto A, Giovanelli A, et al. Evaluation of eating habits and lifestyle in patients with obesity before and after bariatric surgery: a single Italian center experience. Springerplus. 2016;5(1):1–9.CrossRefGoogle Scholar
  20. 20.
    Praveenraj P, Gomes R, Kumar S, Senthilnathan P, Parthasarathi R, Rajapandian S, et al. Management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity: a tertiary care experience and design of a management algorithm. J Minim Access Surg [Internet]. 2016;12(4):342. Available at: http://www.journalofmas.com/text.asp?2016/12/4/342/181285CrossRefGoogle Scholar
  21. 21.
    Baltasar A, Serra C, Bengochea M, Bou R, Andreo L. Use of Roux limb as remedial surgery for sleeve gastrectomy fistulas. Surg Obes Relat Dis [Internet]. 2008;4(6):759–63.  https://doi.org/10.1016/j.soard.​2008.07.012.CrossRefGoogle Scholar
  22. 22.
    Márquez MF, Ayza MF, Lozano RB, Del Mar Rico Morales M, García Díez JM, Poujoulet RB. Gastric leak after laparoscopic sleeve gastrectomy. Obes Surg. 2010;20(9):1306–11.CrossRefGoogle Scholar
  23. 23.
    Thompson CE, Ahmad H, Lo Menzo E, Szomstein S, Rosenthal RJ. Outcomes of laparoscopic proximal gastrectomy with esophagojejunal reconstruction for chronic staple line disruption after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis [Internet]. 2014;10(3):455–9.  https://doi.org/10.1016/j.soard.2013.10.008.CrossRefGoogle Scholar
  24. 24.
    Deslauriers V, Beauchamp A. Endoscopic management of post-laparoscopic sleeve gastrectomy stenosis. Surg Endosc. 2012;1:822–5.Google Scholar
  25. 25.
    Greco F. Conversion of vertical sleeve gastrectomy to a functional single-anastomosis gastric bypass: technique and preliminary results using a non-adjustable ring instead of stapled division. Obes Surg [Internet]. 2017;27(4):896–901.  https://doi.org/10.1007/s11695-​016-2392-9.CrossRefGoogle Scholar
  26. 26.
    Moszkowicz D, Rau C, Guenzi M, Zinzindohoué F, Berger A, Chevallier JM. Laparoscopic omega-loop gastric bypass for the conversion of failed sleeve gastrectomy: early experience. J Visc Surg [Internet]. 2013;150(6):373–8.  https://doi.org/10.1016/j.jviscsurg.​2013.08.010.CrossRefGoogle Scholar
  27. 27.
    Zhang L, Tan WH, Chang R, Eagon JC. Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass. Surg Endosc. 2015;29(6):1316–20.CrossRefGoogle Scholar
  28. 28.
    Victorzon M. Revisional bariatric surgery by conversion to gastric bypass or sleeve-good short-term outcomes at higher risks. Obes Surg. 2012;22(1):29–33.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Alcides José Branco Filho
    • 1
  • André Thá Nassif
    • 1
  1. 1.Department of Bariatric SurgeryCuritibaBrazil

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