Revisional Bariatric Surgery

Veronica Gorodner, MD, Barbara Helman, MD, Rudolf Buxhoeveden, MD, Alejandro Grigaites, MD

Programa de Unidades Bariatricas

BACKGROUND: revisional bariatric surgery has been associated with higher complication rate, and less weight loss when compared to primary bariatric surgery. Additionally, if revisional surgery should be done in one or two stages is still a matter of debate. Our goal was to evaluate outcomes after primary vs. revisional bariatric surgery in our experience.

METHODS AND PROCEDURES: retrospective analysis of prospective collected data. Patients were divided into 2 groups; Group A: primary surgery such as Roux –en- Y gastric bypass (RYGB), and sleeve gastrectomy (SG), and Group B: revisional surgery such as pouch resection (PR), band to RYGB (BB), sleeve to RYGB (SB), band to sleeve (BS). Demographics, operative time, length of stay, weight loss, morbidity and mortality were evaluated.

RESULTS: group A: 908 patients, (720 RYGB and 188 SG), age 40±11 years, 69% women; Group B 24 patients, 1 PR, 16 BB (11 done in one stage), 1 SB, and 6 BS (2 done in one stage); age 42±11, 79% women. Preoperative BMI was 47±8 and 42±7 respectively (p <0.001).

%EWL Group A Group B p
3 mo 48±11 36±12 < 0.001
6 mo 60±13 53±17 < 0.001
12 mo 70±14 50±18 < 0.001
24 mo 75±16 69±30 NS
3 yrs 64±18 63±17 NS

Operative time was 107±23 y 153±59 respectively (p <0.001). Hospital stay was 2 days for both groups.

Complications Group A Group B p
Bleeding 17 (2%) 1 (4%) NS
Leak 1 (0.1%) 0 NS
Internal hernia 5 (0.5%) 0 NS
Stenosis 44 (5%) 0 NS
Ulcer 18 (2%) 1 (4%) NS
PE 0 0 NS
Mortality 0 0 NS

CONCLUSIONS: in our experience, revisional bariatric surgery was associated with longer operative time, y fewer weight loss when compared to primary surgery, even though that difference vanished towards the 2 year follow up. There was no statistically significant difference in terms of complications among groups. Revisional bariatric surgery would be a valid option in patients with weight regain.

Session: Poster Presentation

Program Number: P465

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