Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2018 Jun;403(4):473-479.
doi: 10.1007/s00423-018-1675-0. Epub 2018 Apr 20.

Short-term outcomes of sleeve gastrectomy conversion to R-Y gastric bypass: multi-center retrospective study

Cristian Eugeniu Boru  1 , Francesco Greco  2 , Piero Giustacchini  3 , Marco Raffaelli  3 , Gianfranco Silecchia  4
Affiliations
Comparative Study

Short-term outcomes of sleeve gastrectomy conversion to R-Y gastric bypass: multi-center retrospective study

Cristian Eugeniu Boru et al. Langenbecks Arch Surg. 2018 Jun.

Abstract

Introduction: The outcomes of failed laparoscopic sleeve gastrectomies (LSG) converted to laparoscopic standard R-Y gastric bypass (LRYGB) in case of insufficient weight loss (IWL), weight regain (WR), and/or severe gastro-esophageal reflux disease (GERD) are scanty.

Purpose: To evaluate incidence, indications, and short-term outcomes of LSG conversion to LRYGB in three bariatric centers.

Methods: Patients operated between January 2012 and December 2016 by primary LSG, with mean follow-up of 24 months and converted to LRYGB for IWL, WR, and/or GERD, were retrospectively analyzed for demographics, operative details, perioperative complications, comorbidities evolution, and further WL.

Results: Thirty patients (2.76%, 7 M/23 F, mean age 41 ± 10.1 years, initial mean BMI 46.9 ± 6.3 kg/m2) were successfully converted after a mean period of 33 ± 27.8 months for severe GERD (15 patients, 50%), GERD and IWL/WR (3 patients, 10%), and IWL/WR (12 patients, 40%). Surgical complications occurred in three patients (10%). Mean BMI at revision time was 36 ± 9 kg/m2, and 30.8 ± 5.2, 28 ± 4.9, and 28 ± 4.3 kg/m2 after 6, 12, and 24 months, respectively. Resolution of GERD was achieved in 83% of cases. Overall, postoperative satisfaction was reported by 96% of the cases, after mean follow-up of 24 ± 8.9 months.

Conclusions: In high-volume centers, where strict criteria for patients' selection for LSG are applied, the expected incidence of reoperations for "non-responder" (IWL/WR) or de novo or persistent severe GERD non-responder to medical treatment is low (< 3%). Conversion of "non-responder" LSG to LRYGB is effective for further WL and GERD remission at short term (2 years follow-up); however, a high postoperative complication rate was observed. Long-term multidisciplinary follow-up is mandatory to confirm data on WL durability and comorbidity control.

Keywords: Conversion; GERD; Gastric bypass; Insufficient weight loss; Outcomes; Sleeve gastrectomy failure; Weight regain.

PubMed Disclaimer

References

    1. Surg Obes Relat Dis. 2016 Nov;12 (9):1646-1651 - PubMed
    1. Surg Endosc. 2016 Jun;30(6):2374-81 - PubMed
    1. Surg Obes Relat Dis. 2016 Sep - Oct;12 (8):1533-1538 - PubMed
    1. Obes Surg. 2017 Jan;27(1):83-89 - PubMed
    1. Obes Surg. 2014 Oct;24(10):1757-63 - PubMed

LinkOut - more resources