ANALYSIS OF REVISIONAL BARIATRIC SURGERY OUTCOMES: INDICATIONS, TECHNIQUE AND RESULTS
Keywords:
Revisional bariatric surgery, conversion, gastric bypass, insufficient weight loss, complications, reoperation.Abstract
This article provides an analysis of revisional bariatric surgery outcomes based on current literature and clinical studies. The main indications for revisional interventions have been studied, including insufficient weight loss (40-60% of cases), technical complications (20-30%), and metabolic disorders (10-15%). Various types of revisional operations were analyzed: conversion of primary procedures, reconstructive interventions, and repeat restrictive operations. The study showed that the most common revisional procedures are conversion of sleeve gastrectomy to Roux-en-Y gastric bypass (35-45% of cases) and gastric band removal with subsequent conversion (25-30%). Postoperative morbidity after revisional operations is 15-25%, which exceeds the rates of primary interventions. Factors affecting the success of revisional operations have been identified, and recommendations for optimizing patient selection and surgical tactics are proposed.
References
Angrisani L, Santonicola A, Iovino P, et al. Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017;27(9):2279-2289. DOI: 10.1007/s11695-017-2666-x
Welbourn R, Hollyman M, Kinsman R, et al. Bariatric Surgery Worldwide: Baseline Demographic Description and One-Year Outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg. 2019;29(3):782-795. DOI: 10.1007/s11695-018-3593-1
Shantavasinkul PC, Omotosho P, Corsino L, Portenier D. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016;12(9):1640-1645. DOI: 10.1016/j.soard.2016.08.028
Karmali S, Brar B, Shi X, Sharma AM, de Gara C, Birch DW. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922-1933. DOI: 10.1007/s11695-013-1070-4
Dapri G, Cadière GB, Himpens J. Laparoscopic conversion of Roux-en-Y gastric bypass to sleeve gastrectomy as first step approach for weight regain. Obes Surg. 2011;21(10):1546-1550. DOI: 10.1007/s11695-011-0471-0
Voorwinde V, Steenhuis MH, Janssen IM, Berends FJ, Hazebroek EJ. Weight regain in a large cohort of patients after gastric bypass surgery. Obes Surg. 2020;30(3):900-906. DOI: 10.1007/s11695-019-04285-w
Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update. Obesity (Silver Spring). 2013;21 Suppl 1:S1-27. DOI: 10.1002/oby.20461
Capoccia D, Coccia F, Paradiso F, et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a case-control study. Obes Surg. 2018;28(9):2592-2598. DOI: 10.1007/s11695-018-3227-7
Parmar CD, Bryant C, Patel M, et al. One-step laparoscopic gastric bypass to sleeve gastrectomy conversion. Surg Obes Relat Dis. 2017;13(1):24-29. DOI: 10.1016/j.soard.2016.05.023
Salminen P, Helmiö M, Ovaska J, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity. JAMA. 2018;319(3):241-254. DOI: 10.1001/jama.2017.20313
Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248-256. DOI: 10.1016/j.amjmed.2008.09.041
Teshaev, O. R., Ruziev, U. S., Murodov, A. S., & Zhumaev, N. A. (2019). THE EFFECTIVENESS OF BARIATRIC AND METABOLIC SURGERY IN THE TREATMENT OF OBESITY. Toshkent tibbiyot akademiyasi axborotnomasi, (5), 132-138.
Dapri G, Cadière GB, Himpens J. Laparoscopic conversion of adjustable gastric banding and sleeve gastrectomy to Roux-en-Y gastric bypass: technique and preliminary outcomes. Obes Surg. 2009;19(8):1128-1132. DOI: 10.1007/s11695-009-9829-z
Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients before and after sleeve gastrectomy. Obes Surg. 2009;19(11):1515-1521. DOI: 10.1007/s11695-009-9954-8
Iannelli A, Dainese R, Piche T, Facchiano E, Gugenheim J. Laparoscopic sleeve gastrectomy for morbid obesity. World J Gastroenterol. 2008;14(6):821-827. DOI: 10.3748/wjg.14.821
Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319-324. DOI: 10.1097/SLA.0b013e3181e90b31
