Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass--indications and outcome.

Abstract:

BACKGROUND:Due to excellent weight loss success in the short-time follow-up, sleeve gastrectomy (SG) has gained popularity as sole and definitive bariatric procedure. In the long-term follow-up, weight loss failure and intractable severe reflux can necessitate further surgical intervention. METHODS:A retrospective analysis of laparoscopic conversions from SG to Roux-en-Y gastric bypass (RYGB) was performed to assess the efficacy for reflux relief and weight loss success. RESULTS:A total of eight out of 73 patients (11%) underwent conversion to RYGB for severe reflux (n=3) or weight regain (n=5) after a median interval of 33 months following laparoscopic sleeve gastrectomy. In one of the patients, a banded gastric bypass was performed. In both groups, conversion to RYGB was successful, as proton pump inhibitor medication could be discontinued in all patients presenting with severe reflux, and a significant weight loss could be achieved in the patients with weight regain within a median follow-up of 33 months. Postoperative complications were observed in only one patient as leakage at the gastrojejunostomy was successfully treated by temporary stent placement. CONCLUSION:Conversion to RYGB is an effective treatment for weight regain or intractable reflux symptoms following SG. Thus, SG can be performed, intended as sole and definitive bariatric intervention, with conversion from SG to RYGB as an exit strategy for these complications.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Langer FB,Bohdjalian A,Shakeri-Leidenmühler S,Schoppmann SF,Zacherl J,Prager G

doi

10.1007/s11695-010-0125-z

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

835-40

issue

7

eissn

0960-8923

issn

1708-0428

journal_volume

20

pub_type

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