Revision Surgery in Bariatric Surgery: Initial Experience

Abstract

A AB BS ST TR RA AC CT T OOb bj je ec ct ti iv ve e: : Revision surgery in bariatric surgery is becoming an important issue. It has been associated with higher complication rates, and there is no consensus on the standardized surgical approach to revision surgery. The aim of this study was to review the revision procedures performed in our institute. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A retrospective review of a prospectively maintained database was performed. One hundred thirty three operations were performed for morbid obesity. Primary procedures were laparoscopic adjustable gastric banding (LAGB) in 61 patients, vertical band gastroplasty (VBG) in 24 patients, Roux-en-Y gastric bypass in 21 patients, sleeve gastrectomy in 10 patients and biliopancreatic diversion with duodenal switch in six patients. Eleven patients were reoperated due to mechanical complications or inadequate weight loss. Data including age, gender, preoperative weight, body mass index (BMI) and postoperative complications were reviewed for all patients undergoing a revision procedure. R Re es su ul lt ts s: In patients with previous VBG, failure of weight loss (3/4) and outlet stenosis (1/4) were the indications. In patients with previous LAGB, mechanical side effects were the indications of surgery. The gastrocolic fistula was the indication of surgery in patient who had been revised from VBG to sleeve gastrectomy. At the mean follow-up of 13 months, the mean BMI and percentage of excess BMI were 32.3 kg/m 2 and 37.4%, respectively. There was one stapler-line leakage. C Co on nc cl lu us si io on n: : Our study suggests that revision bariatric surgery can be performed with satisfactory short-term weight loss. The knowledge of the potential complications associated with revision surgery and their management is crucial for patients' safety. K Ke ey y W Wo or rd ds s: : Obesity; bariatric surgery; reoperation; body mass index Ö ÖZ ZE ET T A Am ma aç ç: : Bariatrik cerrahide revizyonel cerrahi önemli bir konu haline gelmektedir. Yüksek komplikasyon oranları ile ilişkili bulunmuştur ve revizyonel cerrahide standart cerrahi yaklaşımla ilgili fikir birliği yoktur. Bu çalışmanın amacı bizim merkezimizde yapılan revizyonel cerrahilerin göz-den geçirilmesidir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : İleri dönük olarak sürdürülen veri tabanı geriye dönük olarak gözden geçirildi. Morbid obezite nedeniyle 133 ameliyat yapıldı. Birincil ameliyat 61 hastada laparoskopik ayarlanabilir gastrik bantlama (LAGB), 24 hastada vertikal bantlı gastroplasti (VBG), 21 hastada Roux-en-Y gastrik baypas, 10 hastada sleeve gastrektomi ve altı hastada duodenal switch ile biliopankreatik diversiyondu. Onbir hasta mekanik komplikasyonlar veya yetersiz kilo kaybı nedeniyle tekrar ameliyat edildi. Yaş, cinsiyet, ameliyat öncesi ağırlık, beden kitle indeksi (BKİ) (bariatrik ve revizyonel cerrahiden önce) ve postoperatif komplikasyonları içeren veriler revizyon işlemi yapılan tüm hastalarda gözden geçirildi. B Bu ul lg gu ul la ar r: : D...