Mid-Term Outcomes After Conversion Procedures Following Laparoscopic Sleeve Gastrectomy.

Area of Science:

• Bariatric surgery outcomes
• Gastrointestinal surgery research

Background:

• Laparoscopic sleeve gastrectomy (SG) may lead to long-term issues like insufficient weight loss (IWL) and gastroesophageal reflux disease (GERD).
• Revisional surgery after SG is considered to manage these complications and improve patient outcomes.

Purpose of the Study:

• To evaluate mid-term results of patients converted after SG.
• Assessing weight loss (WL), resolution of associated medical problems, and reoperation rates post-conversion.

Main Methods:

• Retrospective analysis of 71 patients who underwent conversion after SG with a minimum 2-year follow-up.
• Conversions included short biliopancreatic limb Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with duodenal switch (BPD/DS), long biliopancreatic limb RYGB, and re-sleeve gastrectomy (RSG).

Main Results:

• BPD/DS and long BPL RYGB resulted in the greatest percentage of total weight loss (%TWL) compared to RSG.
• Conversion to RYGB resolved GERD symptoms in 79.5% of patients.
• 16.9% of patients required an additional revisional procedure.

Conclusions:

• Conversion to BPD/DS is effective for significant and sustainable weight loss in cases of IWL after SG.
• Conversion to RYGB reliably controls GERD symptoms post-SG.