Idan Carmeli1, Inbal Golomb2, Eran Sadot1, Hanoch Kashtan1, Andrei Keidar3. 1. Department of Surgery Rabin Medical Center, Campus Beilinson, Petach Tiqva, Israel. 2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Department of Surgery Rabin Medical Center, Campus Beilinson, Petach Tiqva, Israel. Electronic address: keidar66@yahoo.com.
Abstract
BACKGROUND: Failed sleeve gastrectomy (SG), defined by inadequate weight loss or weight regain, can be treated by a laparoscopic conversion to a biliopancreatic diversion with duodenal switch (DS) or a Roux-en-Y gastric bypass (RYGB). We report the outcomes of these procedures after SG failure. METHODS: All patients who underwent DS (n=9) or RYGB (n=10) due to inadequate weight loss or weight regain between December 2006 and November 2012 after a failed SG were enrolled. RESULTS: The mean pre-SG weight and body mass index (BMI) for the DS and RYGB patients were 143±36 kg and 51.5±11 kg/m2 and 120±26 kg and 44.5±5 kg/m2, respectively. The interval between the SG and the conversion to DS and to RYGB was 27±18 months and 36±17 months, respectively. The operation time and hospital stay were 191±64 minutes and 4.3±2.4 days for DS, and 111±37 minutes and 3.1±1.1 days for RYGB. At reoperation, the weight, BMI and percentage of excess weight loss (%EWL) were 113±22 kg, 43±6 kg/m2 and 28±16.5% and 107±27.5 kg, 40±5.7 kg/m2 and 25±12.7% (all P>.05), for the DS and RYGB, respectively. None of the patients were lost to follow-up. The post-DS weight, BMI, and %EWL were 84±19 kg, 30.7±7.4 kg/m2, and 80±40%. The post-RYGB weight, BMI, and %EWL were 81±21 kg, 30.2±4.8 kg/m2, and 65.5±34% (all P>.05). CONCLUSION: DS and RYGB are feasible and effective operations after a failed SG. The DS yields a greater weight loss. The mechanism of failure should guide selection of the second procedure.
BACKGROUND: Failed sleeve gastrectomy (SG), defined by inadequate weight loss or weight regain, can be treated by a laparoscopic conversion to a biliopancreatic diversion with duodenal switch (DS) or a Roux-en-Y gastric bypass (RYGB). We report the outcomes of these procedures after SG failure. METHODS: All patients who underwent DS (n=9) or RYGB (n=10) due to inadequate weight loss or weight regain between December 2006 and November 2012 after a failed SG were enrolled. RESULTS: The mean pre-SG weight and body mass index (BMI) for the DS and RYGB patients were 143±36 kg and 51.5±11 kg/m2 and 120±26 kg and 44.5±5 kg/m2, respectively. The interval between the SG and the conversion to DS and to RYGB was 27±18 months and 36±17 months, respectively. The operation time and hospital stay were 191±64 minutes and 4.3±2.4 days for DS, and 111±37 minutes and 3.1±1.1 days for RYGB. At reoperation, the weight, BMI and percentage of excess weight loss (%EWL) were 113±22 kg, 43±6 kg/m2 and 28±16.5% and 107±27.5 kg, 40±5.7 kg/m2 and 25±12.7% (all P>.05), for the DS and RYGB, respectively. None of the patients were lost to follow-up. The post-DS weight, BMI, and %EWL were 84±19 kg, 30.7±7.4 kg/m2, and 80±40%. The post-RYGB weight, BMI, and %EWL were 81±21 kg, 30.2±4.8 kg/m2, and 65.5±34% (all P>.05). CONCLUSION:DS and RYGB are feasible and effective operations after a failed SG. The DS yields a greater weight loss. The mechanism of failure should guide selection of the second procedure.
Authors: Chetan D Parmar; Kamal K Mahawar; Maureen Boyle; Norbert Schroeder; Shlok Balupuri; Peter K Small Journal: Obes Surg Date: 2017-07 Impact factor: 4.129
Authors: Jeffrey Qiu; Peter W Lundberg; T Javier Birriel; Leonardo Claros; Jill Stoltzfus; Maher El Chaar Journal: Obes Surg Date: 2018-09 Impact factor: 4.129