Abdelrahman A Nimeri, MD, FACS, Mohamed B Al Hadad, MD, Maha Ibrahim, MD, Rana Kurdi, PhD, Cother Hajat, MD, MPH. Division of general, thoracic and vascular surgery Sheikh Khalifa Medical City managed by Cleveland clinic.
The UAE has the second highest rate of type 2 DM and obesity in the world. Bariatric surgery is the most effective long term solution for morbid obesity. However, many patients fail to lose weight, regain their lost weight or develop complications necessitating revisional bariatric surgeries. outcomes of bariatric surgery from the UAE are not known.
We reviewed our prospectively maintained database for revisional bariatric surgeries at Bariatric and Metabolic Institute (BMI) Abu Dhabi from June 2009 to June 2013. Patient demographics, types of operation and perioperative outcomes were evaluated. EWL% for LAGB conversion patients are calculated based on the weight prior to LAGB conversion.
A total of 444 bariatric surgeries were done at BMI Abu Dhabi, of these 83/444 (18.7%) patients were for LAGB failure. Forty six patients (56%) had LAGB reversal, and 37 patients 44%) had LAGB removal and conversion to RYGB. The conversion was done in one stage in 31/37 (84%) of patients. Average age for the LAGB reversal and conversion was 36 (20-51) and 33 (16-44) years. Females represented 71% and 76% of the LAGB reversal and conversion patients . Average BMI for the LAGB reversal and conversion was 37 (23-54) and 47 (32-71) Kg/m2. Length of stay for the LAGB reversal and conversion was 1 and 2 days. Our leak rate for LAGB reversal and conversion was 0% and 2.7%, stenosis 0%, pneumonia 0% and 2.9%, conversion to open 0%, re admission 0% and 6%, bleeding requiring blood transfusion 0%, line sepsis 0% and 2.7%, gall stones requiring cholecystectomy 0% and 2.4% and Mortality 0%. EWL% at 12 months 61% (45%FU) which is lower than our primary RYGB series 76% at 12 months.
LAGB failure was the commonest reason for revisional bariatric surgery at BMI Abu Dhabi. Conversion to RYGB in one stage is our preferred strategy. EWL% of revisional RYGB is inferior to primary RYGB at one year.