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
. 2022 Mar;32(3):643-651.
doi: 10.1007/s11695-021-05866-0. Epub 2022 Jan 14.

Outcome of Sleeve Gastrectomy Converted to Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass

D M Felsenreich  1 , K Steinlechner  1 , F B Langer  1 , N Vock  1 , J Eichelter  1 , C Bichler  1 , J Jedamzik  1 , M Mairinger  1 , I Kristo  1 , G Prager  2   3
Affiliations

Outcome of Sleeve Gastrectomy Converted to Roux-en-Y Gastric Bypass and One-Anastomosis Gastric Bypass

D M Felsenreich et al. Obes Surg. 2022 Mar.

Abstract

Purpose: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide but there is also a high conversion rate mainly due to weight regain and gastroesophageal reflux disease (GERD) reported in studies with long-term follow-up. The aim of this study is to highlight benefits and limitations of converting SG patients to Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB).

Setting: Retrospective cross-sectional-study, medical university clinic setting.

Methods: This study includes all patients converted from primary SG to RYGB or OAGB by 12/2018 at the Medical University of Vienna. Patients were examined using gastroscopy, esophageal manometry, 24-h pH-metry, and questionnaires.

Results: Fifty-eight patients were converted from SG to RYGB (n = 45) or OAGB (n = 13). Total weight loss of patients converted to RYGB and OAGB was 41.5% and 44.8%, respectively, at nadir. Six patients had Barrett's esophagus (BE) after SG. In four out of these six patients, a complete remission of BE after conversion to RYGB was observed; nevertheless, two patients after RYGB and one after OABG newly developed BE. Clinical GERD improved at a higher rate after RYGB than after OAGB. Both revisional procedures improved associated medical problems.

Conclusion: Conversion to RYGB is probably the best option for patients with GERD after SG. OAGB has shown a low potential to cure patients from GERD symptoms after SG. In terms of additional weight loss and remission of associated medical problems, both procedures studied were equal. Surveillance gastroscopies every 5 years after SG revisions are recommended.

Keywords: Conversion; GERD; One-anastomosis gastric bypass; Quality of life; Roux-en-Y gastric bypass; Sleeve gastrectomy; Weight regain.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Comment in

References

    1. Garvey WT, Garber AJ, Mechanick JI, et al. American association of clinical endocrinologists and American college of endocrinology position statement on the 2014 advanced framework for a new diagnosis of obesity as a chronic disease. Endocr Pract. 2014;20:977–989. doi: 10.4158/EP14280.PS. - DOI - PMC - PubMed
    1. Angrisani L, Santonicola A, Iovino P, Ramos A, Shikora S, Kow L: Bariatric Surgery Survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg 2021 - PMC - PubMed
    1. Felsenreich DM, Ladinig LM, Beckerhinn P, Sperker C, Schwameis K, Krebs M, et al.: Update: 10 years of sleeve gastrectomy-the first 103 patients. Obes Surg 2018 - PubMed
    1. Mandeville Y, Van Looveren R, Vancoillie PJ, Verbeke X, Vandendriessche K, Vuylsteke P, et al.: Moderating the enthusiasm of sleeve gastrectomy: up to fifty percent of reflux symptoms after ten years in a consecutive series of one hundred laparoscopic sleeve gastrectomies. Obes Surg 2017 - PubMed
    1. Arman GA, Himpens J, Dhaenens J, et al. Long-term (11+years) outcomes in weight, patient satisfaction, comorbidities, and gastroesophageal reflux treatment after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12:1778–1786. doi: 10.1016/j.soard.2016.01.013. - DOI - PubMed