Sleeve Gastrectomy Failure—Revision to Laparoscopic One-Anastomosis Gastric Bypass or Roux-n-Y Gastric Bypass: a Multicenter Study

Shlomi Rayman*, Dan Assaf, Carmil Azran, Gideon Sroka, Ahmad Assalia, Nahum Beglaibter, Ram Elazary, Shai Meron Eldar, Orly Romano-Zelekha, David Goitein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Introduction: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric procedure performed worldwide. However, many patients undergo secondary surgery due to either weight-related and complication-related reasons or both. Conversional options vary with one-anastomosis gastric bypass (OAGB) and Roux-n-Y gastric bypass (RYGB) being the most common. The aim of the study was to assess the safety and efficacy of converting failed LSG to either OAGB or RYGB, and compare weight-related results and post-conversion complications. Methods: Retrospective review of hospital records of patients who underwent conversion from LSG to either RYGB or OAGB due to insufficient weight loss or weight regain in 7 bariatric centers between 2013 and 2019. Data retrieved included demographics, anthropometrics, comorbidities, indication for conversion, conversion type, complications, and weight loss. Results: During the study period, 396 patients were included in the study. Eighty-four (21%) patients were lost to follow-up. RYGB and OAGB were performed in 119 and 144 patients, respectively. Mean age and body mass index (BMI) at revision were 44.2 years (range 19–72) and 40.6 ± 5.9 kg/m2 (range 35–71), respectively. Of these, 191 (73%) were female. Percent total body weight loss (%TWL) was 16% ± 1% for the RYGB group vs. 23% ± 12% for the OAGB group (p = 0.0007) at a median follow-up of 29 months (range 7–78 months) following conversion. Gastroesophageal reflux disease (GERD) was significantly higher 1 year following conversion to OAGB vs. RYGB occurring in 25 (17.4%) and 9 (7.6%) patients, respectively (p = 0.018). Conclusions: Conversion of LSG to OAGB, compared to RYGB, results in increased weight loss but a higher rate of GERD and potential nutritional deficiencies. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)2927-2934
Number of pages8
JournalObesity Surgery
Volume31
Issue number7
DOIs
StatePublished - Jul 2021

Keywords

  • GERD
  • OAGB
  • RYGB
  • Revisional bariatric surgery
  • Sleeve gastrectomy failure
  • Weight regain, insufficient weight loss

Fingerprint

Dive into the research topics of 'Sleeve Gastrectomy Failure—Revision to Laparoscopic One-Anastomosis Gastric Bypass or Roux-n-Y Gastric Bypass: a Multicenter Study'. Together they form a unique fingerprint.

Cite this