Reversal Rather Than Revision of Failed Bariatric Operation

Reversal Rather Than Revision of Failed Bariatric Operations
Operative revision and reversal represent treatment alternatives for patients who fail primary bariatric operations. This review focuses on a small group of patients who had reversal rather than revision of their primary operation.
METHODS: This study reviews 2532 primary and 238 revisional operations that were performed by one surgeon over a 27-year period. Primary operations were performed by other surgeons in 75 of the revision patients. The indications for revision were complications in 73 patients (31%) and weight loss failure in 165 patients (69%).
RESULTS: Ten patients had reversal rather than revision including 5 who requested reversal for severe outlet stenosis after banded restrictive procedures and 5 who were recommended to have reversal due to active abuse of prescription drugs (2) or tobacco (1) and 2 with severe metabolic complications related to malabsorption. Weight regain occurred in all but one patient who was followed for > 12 months. Two patients subsequently requested another bariatric operation after regaining weight, only one of which was performed with 34 % EWL post revision. One of the 10 patients had a post operative wound infection. There were no other complications or deaths in this subgroup.
CONCLUSIONS: Approximately 1.0% of patients who have bariatric surgery will require reversal for troublesome complications. Active substance abuse and non-Compliance with physician’s recommendations contributed towards the decision to reverse rather than revise the primary operation.

Session: Poster

Program Number: P021

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