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Secondary Bariatric Procedures in a High-Volume Centre: Prevalence, Indications and Outcomes

Authors
  • Elshaer, Mohamed1, 2
  • Hamaoui, Karim1
  • Rezai, Parushak1
  • Ahmed, Kasim1
  • Mothojakan, Nadira1
  • Al-Taan, Omer1
  • 1 Luton and Dunstable University Hospital, Department of Upper GI and bariatric Surgery, Luton, UK , Luton (United Kingdom)
  • 2 Luton and Dunstable University Hospital, Department of Surgery, Lewsey road, Luton, LU4 0DZ, UK , Luton (United Kingdom)
Type
Published Article
Journal
Obesity Surgery
Publisher
Springer-Verlag
Publication Date
Mar 21, 2019
Volume
29
Issue
7
Pages
2255–2262
Identifiers
DOI: 10.1007/s11695-019-03838-z
Source
Springer Nature
Keywords
License
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Abstract

BackgroundSecondary bariatric procedures represent a challenge to both patients and surgeons. The objective of this study was to explore the patterns of recurrence and modalities of secondary bariatric procedures in a tertiary bariatric centre.Materials and MethodsA retrospective analysis of patients who underwent secondary bariatric procedures after laparoscopic adjustable gastric band (AGB), sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) from April 2007 to March 2017.ResultsOverall, 3266 bariatric procedures were performed, and secondary bariatric procedures were required for 45 (1.4%) patients (28 AGB, 14 SG, 3 RYGB). Twenty-six (57.8%) patients underwent conversion to RYGB, eight (17.8%) patients underwent conversion to SG, seven (15.6%) patients were converted to duodenal switch (DS), two (4.4%) patients had revision of gastrojejunal anastomosis, one (2.2%) patient underwent revision of gastric pouch and one (2.2%) patient had replacement of AGB. Mean change in BMI and %TWL at 18 months were 8.5 ± 3.9 kg/m2 and 17.6 ± 8.2 respectively after revision of AGB. Mean change in BMI and %TWL at 18 months were 11.7 ± 11.2 kg/m2 and 18.4 ± 13.2 respectively after revision of SG. Mean change in BMI and %TWL at 18 months were 2.6 ± 3.0 kg/m2 and 6.9 ± 6.8 respectively after revision of RYGB. No mortality was reported after revision procedures.ConclusionWeight regain, inadequate weight loss and reflux were the main reasons for performing secondary bariatric procedures. The main revision procedures performed were RYGB and SG especially for failed AGB.

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