Skip to main content

Advertisement

SpringerLink
Log in

Approach to Poor Weight Loss After Laparoscopic Sleeve Gastrectomy: Re-sleeve Vs. Gastric Bypass

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is increasing worldwide; however, long-term follow-up results included insufficient weight loss and weight regain. This study aims at assessing the outcomes of converting LSG to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic re-sleeve gastrectomy (LRSG).

Methods

A total of 1300 patients underwent LSG from 2009 to 2012, of which 12 patients underwent LRYGB and 24 patients underwent LRSG in Al-Amiri Hospital alone. Data included length of stay, percentage excessive weight loss (EWL%), and body mass index (BMI).

Results

Twenty-four patients underwent conversion from LSG to LRSG, and 12 patients underwent conversion from LSG to LRYGB due to insufficient weight loss and weight regain. Eighty-five percent were females. The mean weight and BMI prior to LSG for the LRYGB and LRSG patients were 136.5 kg and 52, and 134 kg and 50, respectively. The EWL% after the initial LSG was 37.9 and 43 %, for LRYGB and LRSG, respectively. There were no complications recorded. Results of conversion of LSG to LRYGB involved a mean EWL% 61.3 % after 1 year (p value 0.009). Results of LRSG involved a mean EWL% of 57 % over interval of 1 year (p value 0.05). Comparison of the EWL% of LRYGB and LRSG for failed primary LSG was not significant (p value 0.097).

Conclusion

Following our algorithm, revising an LSG with an LRSG or LRYGB for poor weight loss is feasible with good outcomes. Larger and longer follow-up studies are needed to verify our results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Baltasar A, Serra C, Pérez N, et al. Re-sleeve gastrectomy. Obes Surg. 2006;16:1535–8.

    Article  PubMed  Google Scholar 

  2. Himpen J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity.

  3. National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res. 1998;6:51S–209S.

    Article  Google Scholar 

  4. Almazeedi S, Al Sabah S, Alshammari D. Routine trans-abdominal ultrasound before laparoscopic sleeve gastrectomy. Obes Surg. 2013. doi:10.1007/s11695-013-1092-y.

    PubMed  Google Scholar 

  5. Almazeedi S, Al-Sabah S, Alshammari D, et al. The impact of Helicobacter pylori on the complications of laparoscopic sleeve gastrectomy. Obes Surg. 2014;24(3):412–5. doi:10.1007/s11695-013-1108-7.

    Article  PubMed  Google Scholar 

  6. Gagner M. 5th international consensus summit for sleeve gastrectomy: is there a consensus. Bariatric Times. 2015;12(4 Supple A):A22–3.

    Google Scholar 

  7. Gagner M, Gumbs A. Gastric banding: conversion to sleeve, bypass, or DS. Surg Endosc. 2007;21(11):1931–5.

    Article  PubMed  Google Scholar 

  8. Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20:535–40.

    Article  PubMed  Google Scholar 

  9. Langer FB, Bohdjalian A, Shakeri-Leidenmühler S, et al. Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass-indications and outcome. Obes Surg. 2010;20:835–40.

    Article  PubMed  Google Scholar 

  10. Deguines JB, Verhaeghe P, Yzet T, et al. Is the residual gastric volume after laparoscopic sleeve gastrectomy an objective criterion for adapting the treatment strategy after failure? Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2006;9:660–6.

    Article  Google Scholar 

  11. Zundel N, Hernandez JD. Conversional surgery after restrictive procedures for morbid obesity. Surg Laparosc Endosc Percutan Tech. 2010;20:338–43.

    Article  PubMed  Google Scholar 

  12. Switzer NJ, Karmali S. The sleeve gastrectomy and the how and why it can fail? Surg Curr Res. 2006;4:3.

    Google Scholar 

  13. Langer FB, Bohdjalian A, Felberbaure F, et al. Does gastric dilatation limit the success of sleeve gastrectomy as a sole operation for morbid obesity? Obes Surg. 2006;16:166–71.

    Article  PubMed  Google Scholar 

  14. Iannelli A, Schneck AS, Noel P, et al. Re-sleeve gastrectomy for failed laparoscopic sleeve gastrectomy: a feasibility Study. Obes Surg. 2011;21:832–5.

    Article  PubMed  Google Scholar 

  15. Cesana G, Uccelli M, Ciccarese F, et al. Laparoscopic re-sleeve gastrectomy as a treatment of weight regain after sleeve gastrectomy. World J Gastrointest Surg. 2014;6(6):101–6.

    PubMed  PubMed Central  Google Scholar 

  16. Sarwer DB, Dilks RJ, West-Smith L. Dietary intake and eating behavior after bariatric surgery: threats to weight loss maintenance and strategies for success. Surg Obes Relat Dis. 2011;7(5):644–51.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Al-Amiri Hospital, Kuwait City, Kuwait

    Salman AlSabah, Nourah Alsharqawi, Ahmed Almulla, Shehab Akrof, Khaled Alenezi, Waleed Buhaimed, Saud Al-Subaie & Mohanned Al Haddad

Authors
  1. Salman AlSabah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nourah Alsharqawi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ahmed Almulla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shehab Akrof
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Khaled Alenezi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Waleed Buhaimed
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Saud Al-Subaie
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mohanned Al Haddad
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Salman AlSabah.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

AlSabah, S., Alsharqawi, N., Almulla, A. et al. Approach to Poor Weight Loss After Laparoscopic Sleeve Gastrectomy: Re-sleeve Vs. Gastric Bypass. OBES SURG 26, 2302–2307 (2016). https://doi.org/10.1007/s11695-016-2119-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-016-2119-y

Keywords

Search

Navigation