Bariatric Surgery Revisions after Unsuccessful Weight Loss: Outcomes and Complications

Abhishek Srivastava, MD, Stelin Johnson, PA, Jenny J Choi, MD, Diego R Camacho, MD, Pratibha Vemulapalli, MD. Department of Surgery, Montefiore Medical Center, Albert Einstein Medical College, Bronx, NY.

Introduction and Objectives
There are increasing numbers of patients who require revisional bariatric surgery either due to unsuccessful weight loss or complications due to their primary procedures. Revisional bariatric surgery has 10% incidence of major complications. The aim of this study was to review our experience with bariatric patients undergoing revisional surgery.

Methods
From April 2009 to May 2013, 142 patients underwent revisional bariatric surgery at our institution. We conducted a retrospective analysis to review revisional bariatric procedures and assess their postoperative outcomes and complications at 1 year after the surgery.

Results
The mean age at revision was 45.1 ± 11.3 years, Mean weight before revision was 280 ± 70 lbs and the mean BMI was 46.1 ± 12.7 kg/m2. Mean duration until revision after initial surgery was 6.1 ± 2.3 years. 77 (54.2%) patients underwent band to bypass revision, 10 (7%) patients underwent band to sleeve revision, 40 (28.1%) patients underwent bypass revisions and 15 (10%) patients underwent other forms of revision. Mean hospital stay after surgery was 3.4 ± 1.2 days. Mean weight 1 year after surgery was 218.1 ± 60 lbs 1 year after revision. Mean BMI was 36.7  ± 14.3 kg/m2. Only 6 (4.2%) patients required post-operative transfusion and 1 (0.7%) patient was re-admitted with anastomotic leak.

Conclusions
Revisional bariatric surgery effectively treated the undesirable results from primary bariatric surgery with very low complication rates in our experience.

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