Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis

Kermansaravi, Mohammad; Jazi, Amir Hossein Davarpanah; Shahabi, Shahab; Eghbali, Foolad; Valizadeh, Rohollah; Rezvani, Masoud

doi:10.1007/s13304-020-00961-w

Cited by 32 publications

(20 citation statements)

References 14 publications

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“…Alternative revision procedures after RYGB are biliopancreatic diversion with duodenal switch, distal RYGB gastric banding or laparoscopic pouch resizing, banding over pouch and/or revision of gastro-jejunal anastomosis. However, the best results in terms of weight loss are achieved by biliopancreatic diversion with duodenal switch and distal RYGB, especially in a 5-year follow-up [ 34 , 35 ]. In our study, we found 6 patients who underwent pouch resizing and 4 who underwent anastomotic revisions.…”

Section: Discussionmentioning

confidence: 99%

Revisional operations among patients after surgical treatment of obesity: a multicenter Polish Revision Obesity Surgery Study (PROSS).

Major¹,

Zarzycki²,

Rymarowicz³

et al. 2022

Videosurgery and Other Miniinvasive Techniques

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Introduction Revisional surgery is more technically challenging and associated with increased morbidity and mortality. Nevertheless, the frequency of revisional bariatric surgery (RBS) is increasing. Therefore, investigating this group of patients appears to be currently valid. Aim The objective of this multicenter study was to collect, systematize and present the available data on RBS after surgical treatment of morbid obesity among Polish patients. Material and methods This multicenter study included a retrospective analysis of a prospectively maintained database. Outcomes included an analysis of the indications for RBS, the type of surgery most frequently chosen as RBS and the course of the perioperative period of treatment among patients undergoing RBS. Results The group consisted of 799 patients (624 (78.1%) women, 175 (21.9%) men). The mean age was 38.96 ±9.72 years. Recurrence of obesity was the most common indication for RBS. The most frequently performed RBS procedures were one anastomosis gastric bypass (OAGB) – 294 (36.8%) patients, Roux-en-Y gastric bypass (RYGB) – 289 (36.17%) patients and sleeve gastrectomy (SG) – 172 (21.52%) patients. After primary surgery 63.58% of patients achieved sufficient weight loss, but after RBS only 38.87%. Complications were noted in 222 (27.78%) cases after RBS with GERD being the most common – 117 (14.64%) patients. Conclusions RBS most often concerns patients after SG. The main indication for RBS is weight regain. OAGB and RYGB were the two most frequently chosen types of RBS. Secondary operations lead to further weight reduction. However, RBS are associated with a significant risk of complications.

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Section: Discussionmentioning

confidence: 99%

Revisional operations among patients after surgical treatment of obesity: a multicenter Polish Revision Obesity Surgery Study (PROSS).

Major¹,

Zarzycki²,

Rymarowicz³

et al. 2022

Videosurgery and Other Miniinvasive Techniques

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“… 1 – 3 Surgical and endoscopic options in this scenario include revision of gastric bypass with changes in alimentary or biliopancreatic limb, limb distalization, pouch resizing, LAGB, reduction in gastrojejunal stoma, and transoral gastric outlet reduction (TORe), among others. 10 , 11 , 19 – 23 While some of these procedures such as revision of RYGB and pouch resizing are effective, the associated pitfalls such as creation of new anastomosis, re-operation in a previous surgical field, micronutrient deficiencies, protein calorie malnutrition and even need for parenteral nutrition cannot be overlooked. 20 , 21 Given that reduction in gastrojejunal stoma has suboptimal EWL outcomes, possibly secondary to redilatation of stoma over time, TORe is likely to have similar outcomes.…”

Section: Discussionmentioning

confidence: 99%

Gastric Banding with Previous Roux-en-Y Gastric Bypass (Band over Pouch): Not Worth the Weight

Sohail

Howell

Brathwaite

et al. 2022

JSLS

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“…По данным некоторых авторов, частота ремиссии СД2 в течение первых 3 лет после операции SADI была выше по сравнению с желудочным шунтированием по Ру (RYGB) -более распространенной метаболической операцией [7,8]. Публикации в мировой литературе, посвященные сравнительной оценке двух пилоросохраняющих модификаций БПШ -BPD-DS и SADI, крайне немногочисленны [9][10][11]. В наших недавно вышедших публикациях были показаны преимущества SADI по срав-нению с BPS-DS в плане простоты выполнения, снижения частоты ранних послеоперационных осложнений, послеоперационной белковой недостаточности, поздней тонкокишечной непроходимости [12,13].…”

Section: обоснованиеunclassified

“…СД2 был диагностирован у 35 (35,0%) пациентов из группы 1 (BPD-DS) и у 45 (45,0%) -из группы 2 (SADI). Всем пациентам проводился стандартный комплекс клинических, лабораторных и инструментальных методов обследования до, сразу после и через 3,6,9,12, 18, 24, 36, 48 и 60 мес после операции. РЕЗУЛЬТАТЫ.…”

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Characteristics of carbohydrate metabolism in the surgical treatment of morbid obesity and type 2 diabetes mellitus using various modifications of biliopancreatic diversion with duodenal switch

2022

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BACKGROUND: Biliopancreatic diversion (BPD), and its modifications, is the most effective surgical bariatric treatment of morbid obesity and associated metabolic disturbances. However, at present comparative studies of the dynamics of carbohydrate metabolism after various modifications of the BPD are lacking.AIM: comparative assessment for the effectiveness of biliopancreatic diversion with duodenal switch (BPD-DS) in the HessMarceau and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) modifications for correcting carbohydrate metabolism disorders and achieving remission of Diabetes mellitus type 2 (DM2) within a period of up to five years after both operations.MATERIALS AND METHODS: within the framework of a prospective study, 200 patients with morbid obesity were operated on using the BPD-DS (group 1, n = 100) and SADI (group 2, n = 100) methods, the dynamics of clinical and laboratory parameters was analyzed in groups depending on the presence, or absence, of DM2, with an emphasis on the analysis of indicators of carbohydrate metabolism. DM2 was diagnosed in 35 (35.0%) patients in group 1 (BPD - DS) and 45 (45.0%) in group 2 (SADI). All patients underwent a standard set of clinical, laboratory and instrumental examination methods before, immediately after and at 3, 6, 9, 12, 18, 24, 36, 48 and 60 months after the operation.RESULTS: 5 years after the operation, complete remission of DM2 was achieved in 38 (84.4%) and 32 (91.4%) patients from the SADI and BPD-DS groups, respectively, and 7 (15.6%) and 3 (8.6 %) of patients achieved partial remission. The level of C-peptide, which also decreased after both modifications of BPS, was higher in patients after BPS in the SADI modification, both in patients with DM2 36 months (p<0.05), and in patients without DM2 at 3, 12 and 24 months after surgery (p<0.05).CONCLUSION: The frequency of achieving stable remission of DM2 is comparable in both groups. The carbohydrate profile of patients after SADI is characterized by higher levels of glucose and C-peptide compared to BPD-DS at different periods of follow-up over five years.

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Revision procedures after initial Roux-en-Y gastric bypass, treatment of weight regain: a systematic review and meta-analysis

Cited by 32 publications

References 14 publications

Revisional operations among patients after surgical treatment of obesity: a multicenter Polish Revision Obesity Surgery Study (PROSS).

Revisional operations among patients after surgical treatment of obesity: a multicenter Polish Revision Obesity Surgery Study (PROSS).

Gastric Banding with Previous Roux-en-Y Gastric Bypass (Band over Pouch): Not Worth the Weight

Characteristics of carbohydrate metabolism in the surgical treatment of morbid obesity and type 2 diabetes mellitus using various modifications of biliopancreatic diversion with duodenal switch

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