Short term outcomes of Roux en-Y Gastric bypass vs. re-sleeve gastrectomy for failed weight loss or weight regain after sleeve gastrectomy

Document Type : Original Article

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1 General Surgery Department, Gastrointestinal and Laparoscopic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

2 Public Health and Community Medicine Department ,Faculty of Medicine , Tanta University, Tanta, Egypt

Abstract

Background: Sleeve gastrectomy (SG) is now the most used obesity surgery. There have been reports of different rates for conversion of LSG to other bariatric operations due to various factors such as recurrent weight gain (RWG) and/or failure of weight reduction. The purpose was to evaluate the security and effectiveness of redo after an unsuccessful primary LSG to either LRSG or rLRYGB. Methods: All patients who had SG at Tanta University Hospital in Egypt from July 2017 to July 2023 were included in this retrospective study. Patients with either LRSG or rLRYGB following their previous SG were listed, and their demographics and outcomes were examined. Results: Seven hundred sixty-two patients underwent SG from July 2017 to July 2023, of whom 112 (14.6%) had a conversion. There were 79 individuals with either suboptimal clinical response (SoCR) or recurrent weight gain (RWG). Seventy-three patients had a minimal follow-up ≥12 months after conversion. Four patients were removed from the cohort after undergoing conversions to BPD/duodenal switch following SG. The mean BMI after RSG was 33.6±5.3 kg/m2, and 32.7±5.4 kg/m2 in the RYGB group. Re-sleeve group had a significantly lower operative duration than RYGB, with a mean of 89±12.7 and 168±33.5 minutes, respectively. The length of hospital stay was significantly shorter in RSG 4±0.1 versus 7±1.2 in RYGB. Conclusions: Our results showed that revisional LRSG and rLRYGB after LSG are achievable and secure techniques with favorable weight reduction consequences, sustained weight loss over 1 year, and low complication rates.

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