Conversion From Sleeve Gastrectomy to Gastric Bypass

Oscar E Brasesco, Gaston Borlle, Mario Corengia, Guillermo Muzio, Juan M Riganti, Gabriel Menaldi, Jorge Bella, Guillermo Premolli, Santiago Juarez, Pedro R Martinez-Duartez, MD


INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) was conceived as the first of a two-stage procedure for super-obese patients. However, weight loss results made it gain success as a single bariatric procedure. Reports show low prevalence of leakeage, but difficulties in treatment. Long term complications have been low, but recent articles report 27 to 40% of gastroesophageal reflux disease (GERD) and inadequate weight loss after the 6th postoperative year. The aim of this stud was to determine causes, morbidity, mortality and effectiveness of LSG conversion to Laparoscopic Roux en Y Gastric Bypass (LRYGB).

METHODS: We retrospectively analyzed data from March 2003 to July 2012. Demographic data, conversion causes, time from first procedure to conversion, complications, and excess weight loss at 9 months of conversion was evaluated.

RESULTS: We perform 6049 bariatric surgery operations. 4 patients underwent conversion of LSG to LRYGB, 50% were female, the mean age was 36.5 years (25-55), initial weight 89.5 kg (62-118), and initial BMI 39.44 (20-50). Conversion causes: regained weight 25%, GERD 25%, stricture with food intolerance 25% and leakeage 25%. Complications: gastrojejunal leak in 1 case. No mortality was reported. After nine months of follow up, patient with preoperative stricture and food intolerance regained weight and had a actual BMI of 26, patient with GERD was no longer symptomatic and the patient with preoperative regained weight had a 65.14% of excess weight loss.

CONCLUSIONS: LSG conversion to LRYGB is technically challenging but feasible and effective. Patients with GERD associated with LSG presented no more synthoms and regained weight was lost achieving a better BMI.

Session: Poster Presentation

Program Number: P434

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