Weight Regain After Gastric Plication: Reoperative Sleeve Gastrectomy or Roux-en-Y Gastric Bypass?—Analysis of 116 Consecutive Cases

Chahine, Elias; Alkandari, Mubarak; Simone, Belinda De; Dirani, Mazen; D’Alessandro, Antonio; Saikaly, Elias; Gumbs, Andrew A.; Cartillone, Maria Cristina; Crispo, Luigi; Chouillard, Marc Anthony; Kassir, Radwan; Chouillard, Élie

doi:10.1007/s11695-020-04767-y

Cited by 2 publications

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“…This percentage was comparable to the EWL of 88.2% and 84.1% at 2-years follow-up in two studies by Petrucciani et al 44 and Debs et al, 45 and to the EWL of 79% in a study by Gerges et al 46 evaluating re-OAGB after failure of restrictive procedure. The remarkable difference we found in weight loss outcome (EWL: 86.7% vs 54%) between re-OAGB and re-LSG 2 years after revisional surgery underlines the inferior efficacy of re-adopting a revisional restrictive surgery after an initial failure of primary restrictive surgery, which comes in accordance with two other studies 29,47 that showed a superiority of gastric bypass conversion compared with re-LSG after failure of restrictive surgery. A methodical nutritional follow-up is indispensable post-operatively to monitor the side effects of the malabsorptive aspect of gastric bypass in the long term.…”

Section: Discussionsupporting

confidence: 90%

“…25,26 Up to 56% of patients who underwent VBG had an indication of revisional procedure, especially secondary to weight loss failure. 27 LGP was introduced in 2007 as a restrictive bariatric technique less expensive than LSG; 28 however, follow-up studies are reporting a high rate of unsatisfactory weight loss results 11,29 eventually requiring revisional surgery. In addition, the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) still consider gastric plication as an intervention requiring methodical evaluation of its safety and results.…”

Section: Discussionmentioning

confidence: 99%

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One anastomosis gastric bypass vs sleeve gastrectomy as a revisional bariatric surgery for weight loss failure after primary restrictive procedure

Mouawad,

Dahboul,

Chamaa

et al. 2023

Asian J Endoscop Surgery

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IntroductionWeight loss failure after restrictive bariatric procedures initiated the debate about the choice of an adequate revisional intervention, a question still unanswered. While many surgeons went for a conversion to gastric bypass, others opted for re‐trying a revisional restrictive procedure to avoid the side effects of gastric bypass. The objective of our study was to compare weight loss outcome between revisional laparoscopic sleeve gastrectomy (re‐LSG) and revisional one anastomosis gastric bypass (re‐OAGB) for insufficient weight loss or weight regain following primary restrictive bariatric surgery.Materials and MethodsWe included 20 obese patients, with a history of weight regain or insufficient weight loss after primary restrictive surgery, who underwent re‐LSG (eight patients) or re‐OAGB (12 patients) between January 2018 and January 2021. Patients were followed up 2 years after their revisional intervention. Statistics were performed using IBM® SPSS® software for Windows version 21.ResultsIn the re‐LSG group, the average body mass index (BMI) before primary restrictive procedure was 43.7 kg/m2. The average period between the primary and revisional surgery was 12.6 years. Patients had a nadir BMI of 33.2 kg/m2 during that period and reached a mean BMI of 40.6 kg/m2 before re‐LSG. Two years after re‐LSG, the average BMI was 31.5 kg/m2 with a percent of excess weight loss (%EWL) of 54% and percent of excess BMI loss (%EBMIL) of 66.6%. In the re‐OAGB group, the average BMI before primary restrictive procedure was 39 kg/m2. The average period between the primary and revisional surgery was 10.7 years. Patients had a nadir BMI of 30.5 kg/m2 during that period and reached a mean BMI of 36.5 kg/m2 before re‐OAGB. Two years after re‐OAGB, the average BMI was 27 kg/m2 with a %EWL of 86.7% and %EBMIL of 92.6%.ConclusionFor patients with insufficient weight loss or weight regain following primary restrictive bariatric surgery, re‐OAGB has a better effectiveness in weight reduction compared with re‐LSG after a 2‐year follow up.

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