1. Early postoperative complications after gastric bypass revisional surgery in patients with previous sleeve gastrectomy versus primary gastric bypass.
- Author
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Campo-Betancourth CF, Ortiz Sebastián S, Estrada Caballero JL, Llopis Torremocha C, Villodre Tudela C, Ruiz de la Cuesta García-Tapia E, Gracia Alegría E, Carbonell Morote S, Salas Rezola E, Cárdenas Jaén K, Zapater P, Bernabéu Aguirre C, and Ramia Ángel JM
- Subjects
- Gastrectomy adverse effects, Gastrectomy methods, Humans, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications surgery, Reoperation methods, Retrospective Studies, Treatment Outcome, Weight Gain, Weight Loss, Gastric Bypass adverse effects, Gastric Bypass methods, Gastroesophageal Reflux etiology, Obesity, Morbid complications
- Abstract
Background: Revisional bariatric surgery (RS) is indicated if there is weight regain or insufficient weight loss, no improvement or reappearance of co-morbidities, or previous bariatric surgery complications. It has been associated with higher postoperative morbidity., Objective: To evaluate the early postoperative complications (<30 d) of Roux-en-Y gastric bypass RS (RYGB-RS) after primary sleeve gastrectomy (SG-1) compared with primary RYGB (RYGB-1) at a bariatric surgery referral center., Setting: Department of General and Digestive Surgery of General Universitary Hospital of Alicante, Spain., Methods: Retrospective cohort study comparing RYGB-RS after SG-1 and RYGB-1 between January 2008 and March 2021. Postoperative complications, hospital stay, mortality, and readmissions were analyzed., Results: Six hundred and twenty-eight RYGB surgeries (48 RYGB-RS, 580 RYGB-1) were studied. The mean age of patients undergoing RYGB-RS was 50 years, compared with 46 years in the RYGB-1 group (P = .017). Mean initial body mass index was 44.2 kg/m
2 (RYGB-RS) versus 47.6 kg/m2 (RYGB-1; P = .004). Cardiovascular risk factors were higher in the RYGB-1 group (P < .05). Indications for RS were weight regain or insufficient weight loss (72.9%), weight regain or insufficient weight loss plus gastroesophageal reflux disease (14.6%), and gastroesophageal reflux disease (12.5%). There were no differences in the frequency of complications (RYGB-RS 22.9% vs RYGB-1 20.5%) or in their severity (Clavien-Dindo ≥IIIa; RYGB-RS 10.4% vs RYGB-1 6.4%; P > .05). There were no differences in emergency room visits (RYGB-RS at 12.5% vs RYGB-1 at 14.9%) or in readmissions (RYGB-RS at 12.5% vs RYGB-1 at 9.4%)., Conclusion: No differences were observed between primary RYGB and revisional RYGB in early morbidity, mortality, emergencies, or readmissions. Revisional bariatric surgery is a safe procedure at referral centers and must be done by expert hands., (Copyright © 2022 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)- Published
- 2022
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