BE-CALM: a clinical score to predict weight loss after conversion from sleeve gastrectomy to Roux-en-Y gastric bypass

Dec 16, 2024Surgical endoscopy

BE-CALM: a clinical score to predict weight loss after changing from sleeve gastrectomy to gastric bypass surgery

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

114 patients underwent conversion from sleeve gastrectomy to Roux-en-Y gastric bypass, achieving a peak total body weight loss of 18.8% at 8 months.

Patients had a pre-sleeve gastrectomy average BMI of 49.3.
Post-sleeve gastrectomy, the maximum total body weight loss was 31.2%, with a total body weight regain of 53.9%.
Higher BMI at the time of sleeve gastrectomy was associated with greater weight loss after conversion, with each 5 kg/m² increase linked to 0.8% greater total body weight loss.
A peak excess weight loss of 40% or more after sleeve gastrectomy was associated with an additional 5.5% total body weight loss after conversion.
Patients who experienced a weight regain of 20% or more after sleeve gastrectomy had a 4.1% reduction in total body weight loss after conversion.

AI simplified

BACKGROUND: Conversion from sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB) may be indicated for patients due to insufficient weight loss or weight regain.

OBJECTIVES: To assess weight loss outcomes and factors predictive of improved weight loss in patients undergoing RYGB after SG and create an algorithm to estimate postoperative weight loss in these patients.

SETTING: University Hospital.

METHODS: Retrospective review of patients who underwent conversion from SG to RYGB from 2015 to 2022 was performed, assessing pre-and post-operative weights for each procedure.

RESULTS: 114 patients were included (84% female, pre-SG BMI 49.3 ± 10.2). Post-SG, patients achieved a maximum %TBWL of 31.2% ([6.6-58.2] ± 10.1%), %EWL of 56.8%([13.3-97.3] ± 16.4%), and total body weight regain of 53.9%([0.0-144.4] ± 31.3%). Conversion to RYGB resulted in peak %TBWL of 18.8% at 8 months, leveling off at 13.5% thereafter. Factors predictive of greater weight loss post-conversion included higher BMI at time of SG (each 5 kg/mincrease yielded 0.8% greater %TBWL [95% CI 0.5-1%, p < 0.0001]) and peak %EWL ≥ 40% after SG (yielding 5.5% more %TBWL, 95%CI 3.9-7.1%, p < 0.0001). Conversely, those who had ≥ 20% weight regain after SG had 4.1% less %TBWL (95%CI 2.5-5.7%, p < 0.0001) after conversion. These factors were used to create BE-CALM, an algorithm to predict %TBWL one year after conversion to RYGB. 2

CONCLUSIONS: Conversion from SG to RYGB is effective for further weight loss. Patients who have higher starting BMI, ≥ 40% %EWL or ≤ 20% weight regain after SG demonstrate the most effective weight loss post-conversion.

Full Text

Full text is available at the source.

View full text (PDF) ↗View full text (HTML) ↗

BE-CALM: a clinical score to predict weight loss after conversion from sleeve gastrectomy to Roux-en-Y gastric bypass

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief