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National trends in using revisional surgeries post-sleeve gastrectomy due to reflux and weight recurrence: a matched case-control analysis
National trends in repeat surgeries after sleeve gastrectomy for acid reflux and weight regain: a matched case-control study
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Abstract
Of 25,760 adults who underwent surgical conversion after sleeve gastrectomy, conversions to biliopancreatic diversion with duodenal switch or single-anastomosis duodenoileostomy showed lower odds of 30-day complications compared to Roux-en-Y gastric bypass.
- Patients converting to Roux-en-Y gastric bypass (RYGB) had a lower average preoperative body mass index (39.8) compared to those converting to biliopancreatic diversion with duodenal switch (BPD-DS) or single-anastomosis duodenoileostomy (SADI) (46.1).
- The majority of RYGB conversions were performed for reflux (56.1%), while most BPD-DS and SADI conversions were for weight-related complications (87.3%).
- In matched analyses for weight recurrence, the odds of experiencing 30-day complications were lower for BPD-DS + SADI conversions (odds ratio .73) compared to RYGB (P = .019).
- Patients undergoing BPD-DS + SADI conversions also had lower odds of readmission (odds ratio .77) compared to those converted to RYGB (P = .031).
- No significant differences were found in the odds of 30-day reintervention or reoperation between RYGB and BPD-DS + SADI conversions.
- Hemorrhage rates were higher in RYGB conversions (1.98%) compared to BPD-DS + SADI conversions (0.87%) (P = .001).
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