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. 2022 Oct;32(10):3257-3263.
doi: 10.1007/s11695-022-06248-w. Epub 2022 Aug 23.

Challenges in Bariatric Surgery: Outcomes in Patients Having Three or More Bariatric Procedures

Dario Raglione  1 , Andrea Chierici  1 , Antonio Castaldi  1 , Céline Drai  1   2 , Serena de Fatico  1 , Tagleb S Mazahreh  3 , Luigi Schiavo  4 , Anne-Sophie Schneck  5 , Antonio Iannelli  6   7   8
Affiliations

Challenges in Bariatric Surgery: Outcomes in Patients Having Three or More Bariatric Procedures

Dario Raglione et al. Obes Surg. 2022 Oct.

Abstract

Introduction: Over the last two decades, a progressive increase in failure rate of bariatric surgery (BS) has occurred in conjunction with an exponential increase in BS worldwide. Bariatric surgeons are confronted with challenging situations in patients with a complex bariatric history. In this study, we aim to evaluate the feasibility and outcomes of revisional BS in patients with at least two or more previous bariatric procedures.

Methods: Data were retrospectively retrieved from a prospectively held database of bariatric procedures performed at our tertiary referral bariatric center and included procedures done from February 2013 up to April 2019 by a single center.

Results: Thirty patients underwent a third bariatric procedure. The median age was 40 (18-57) and 54 (27-69) years at the time of the first and the last procedures, respectively. Laparoscopic adjustable gastric banding was the first procedure in 26 patients. The complication rate was 33%; no patient required additional surgery because of postoperative complications. A total weight loss of 29.6% and an excess loss of 53.4% were obtained at a mean follow-up of 61 months after the last redo bariatric procedure.

Conclusion: This study indicates that redo BS either conversional or revisional is feasible and effective in patients with a complex bariatric history including two or more previous procedures. Careful patients' selection is mandatory and extensive information should be given on the increased risk of postoperative complications.

Keywords: Bariatric surgery; Complication; Conversion; Redo; Severe obesity.

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