Outcomes in revisional bariatric surgery: a high-volume single institution experience

Aug 6, 2020Surgical endoscopy

Results of repeat weight-loss surgery at a large hospital

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

266 secondary bariatric procedures were analyzed with significant outcomes observed in weight loss and comorbidity improvement.

AGB to RYGB conversion showed greater percentage of excess BMI loss (%EBMIL) and total body weight loss (%TWL) at 12 and 24 months compared to AGB to SG.
Only AGB to RYGB demonstrated continued improvement in %EBMIL and %TWL at 24 months, while these measures tapered off in other procedures.
Dyslipidemic patients in the AGB to RYGB group had significantly lower cardiovascular risk at 24 months compared to those who underwent AGB to SG.
In the SG to RYGB group, significant cardiovascular risk improvement was noted in dyslipidemic patients at 24 months compared to baseline.
Significant improvements in hemoglobin A1C levels were observed in diabetics across various procedures at 6 to 24 months compared to baseline.

AI simplified

BACKGROUND: This study aims to evaluate outcomes of adjustable gastric band (AGB) conversion to sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB), SG conversion to RYGB and RYGB revision procedures.

METHODS: Patients undergoing secondary bariatric surgery between 2009 and 2017 were retrospectively identified from a prospective database. Primary outcomes were weight loss and improvement in comorbidities. For weight loss, percent of total body weight loss (%TWL) and percentage of excess BMI loss (%EBMIL) were included. Comorbidities included were hemoglobin A1C (HbA1C), cardiovascular risk (CV) and hypertension.

RESULTS: 266 Secondary bariatric procedures were analyzed. There were four Grade IIIb complications within 30 days. There was greater %EBMIL at 12 and 24 months in the AGB to RYGB group, and in %TWL at 24 months compared to AGB to SG group (p < 0.05). Only AGB to RYGB had significantly continued improvement in these two parameters at 24 months compared to at 6 months post-operatively-%EBMIL and %TWL tapered off in the other procedures. There was significantly lower CV risk in dyslipidemic patients at 24 months in the AGB to RYGB compared to the AGB to SG group. In the SG to RYGB patients, there was significant improvement in CV risk in dyslipidemic patients at 24 months compared to baseline. There was significant improvement in HbA1C in diabetics in AGB to RYGB patients at 6 and 12 months, in AGB to SG patients at 12 months, and in SG to RYGB patients at 12 and 24 months compared to baseline. In RYGB revision and SG to RYGB patients, there was a relative increase in the number of patients being normotensive at 24 months compared to baseline.

CONCLUSION: Secondary bariatric surgery is a complex and challenging procedure that may improve weight loss and cardiovascular risk for certain procedures but further studies will be necessary.

Full Text

Full text is available at the source.

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

Outcomes in revisional bariatric surgery: a high-volume single institution experience

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