Weight loss specific to indication, remission of diabetes, and short-term complications after sleeve gastrectomy conversion to Roux-en-Y gastric bypass: a systematic review and meta-analysis

Dec 29, 2022Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Weight Loss, Diabetes Remission, and Short-Term Problems After Changing Sleeve Gastrectomy to Roux-en-Y Gastric Bypass: A Review and Analysis

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Abstract

Overall short-term excess weight loss after sleeve gastrectomy conversion to Roux-en-Y gastric bypass is 54.6%.

Short-term excess weight loss was 53.9% in patients with insufficient weight loss after sleeve gastrectomy.
Medium-term outcomes showed 45.8% excess weight loss in the same group over 2-5 years.
Total weight loss was 19.9% overall in the short term, with 22.7% for those with insufficient weight loss.
Diabetes remission rates were observed at 53% following the conversion.
The perioperative complication rate was 8.2%, indicating a manageable safety profile.

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Laparoscopic sleeve gastrectomy (SG) is the most frequently performed bariatric procedure worldwide. Long-term complications such as insufficient weight loss (IWL) and gastroesophageal reflux disease (GERD) may necessitate SG conversion to Roux-en-Y gastric bypass (RYGB). The aim of this review was to determine the indication-specific weight loss and diabetes remission after SG conversion to RYGB (STOBY). Our objective was to extract all available published data on indication for conversion, weight loss, remission of diabetes, and short-term complications after STOBY. A systematic literature search was conducted to identify studies reporting outcomes following STOBY. A random effects model was used for meta-analysis. The search identified 44 relevant studies. Overall short-term (12-mo) excess weight loss (EWL) was 54.6% (95% confidence interval [CI], 46%-63%) in 23 studies (n = 712) and total weight loss (TWL) was 19.9% (95% CI, 14%-25%) in 21 studies (n = 740). For IWL, short-term (12-mo) pooled weight loss outcomes were 53.9% EWL (95% CI, 48%-59%) in 14 studies (n = 295) and 22.7% TWL (95% CI, 17%-28%) in 12 studies (n = 219), and medium-term (2-5 yr) outcomes were 45.8% EWL (95% CI, 38%-53%) in 7 studies (n = 154) and 20.6% TWL (95% CI, 15%-26%) in 9 studies (n = 206). Overall diabetes remission was 53% (95% CI, 33%-72%), and the perioperative complication rate was 8.2% (95% CI, 7.6%-8.7%). Revisional SG conversion to RYGB for IWL can achieve good weight loss outcomes and diabetes remission.

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Weight loss specific to indication, remission of diabetes, and short-term complications after sleeve gastrectomy conversion to Roux-en-Y gastric bypass: a systematic review and meta-analysis

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