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Roux-en-Y gastric bypass as a re-do procedure for failed restricive gastric surgery

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Abstract

Background

Gastric restrictive procedures such as laparoscopic gastric banding or vertical banded gastroplasty show, at longer follow up, more and more failures and complications. This study focuses on the results of Roux-en-Y gastric bypass procedure (RYGBP) done as a re-do procedure, both after a technically failed restrictive procedure or when the restrictive procedure failed to obtain substantial weight loss.

Methods

We reviewed data concerning the postoperative complications and weight loss of 36 patients undergoing re-do surgery for failed restrictive procedures.

Results

Over a period of two years, 36 patients with a mean age of 40.9 years were converted to a RYGBP. Median time to conversion was 4.9 years, median follow up after conversion was 6.6 months. Early postoperative complications (less than 30 days postoperatively) were noted in 11 patients (30%). A greater number of early complications were noticed in group A (technical complications) compared to group B (insufficient weight loss) (39% vs. 22%). Late postoperative complications were seen in six patients (16%). In this relatively short follow up period we noticed a drop in body mass index (BMI) from a mean of 38.8kg/m2 to 30.9 kg/m2 with a mean excess body weight loss (EBWL) of 33.1% after the re-do procedure. Body mass index decreased from a mean preoperative value of 37.6kg/m2 to 28.9 kg/m2 in group A patients with an EBWL 36%, while group B patients had a change in BMI from 40.1kg/m2 to 32.9 kg/m2 with a mean EBWL of 30%.

Conclusion

Based on the literature, we can presume that restrictive surgery for morbidly obese patients will require many reoperations in the future. The standard operation of choice is RYGBP. In our study this procedure showed a higher, but not significantly early morbidity rate when the indication for re-do surgery was a technical complication of the initial procedure.

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Authors and Affiliations

  1. Abdominal surgery, Universitair ziekenhuis Antwerpen, Antwerp, Antwerpen, Belgium

    Els Van Dessel, Guy Hubens, Martin Ruppert, Lee Balliu & Wouter Vaneerdeweg

  2. Epidemiology and Social Medicine, University of Antwerp, Antwerp, Antwerpen, Belgium

    Joost Weyler

Authors
  1. Els Van Dessel
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  2. Guy Hubens
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  3. Martin Ruppert
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  4. Lee Balliu
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  5. Joost Weyler
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  6. Wouter Vaneerdeweg
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Correspondence to Els Van Dessel.

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Van Dessel, E., Hubens, G., Ruppert, M. et al. Roux-en-Y gastric bypass as a re-do procedure for failed restricive gastric surgery. Surg Endosc 22, 1014–1018 (2008). https://doi.org/10.1007/s00464-007-9576-2

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  • DOI: https://doi.org/10.1007/s00464-007-9576-2

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