Background: Sleeve gastrectomy (SG) frequently requires conversion to Roux-en-Y gastric bypass (RYGB) due to gastroesophageal reflux disease (GERD) or weight recurrence. Current evidence evaluating the safety of conversion from SG to RYGB and its indications is limited to single centers.
Methods: The objective was to determine the rate of serious complications and mortality of conversion of SG to RYGB (SG-RYGB) compared to primary RYGB (P-RYGB). This was a retrospective analysis of the MBSAQIP database which includes 30-day outcomes. Individuals undergoing P-RYGB or SG-RYGB were included. Multivariable logistic regression was performed to determine if revisional surgery was an independent predictor of serious complications or mortality.
Results: In 2020 and 2021, 84,543 (86.3%) patients underwent P-RYGB and 13,432 (13.7%) underwent SG-RYGB. SG-RYGB cohort had lower body mass index, lower rates of diabetes and hypertension, and higher rates of GERD. GERD was the most common indication for revision (55.3%) followed by weight regain (24.4%) and inadequate weight loss (12.7%). SG-RYGB had longer operative times (145 vs. 125 min, p < 0.001) and a higher rate of serious complications (7.2 vs. 5.0%, p < 0.001). This included higher rates of anastomotic leak (0.5 vs. 0.4%, p = 0.002), bleeding (2.0 vs. 1.6%, p < 0.001), and reoperation (3.0 vs. 1.9%, p < 0.001) but not death (0.1 vs. 0.1%, p = 0.385). On multivariable analysis, SG-RYGB was independently predictive of serious complications (OR 1.21, 95%CI 1.12 to 1.32, p < 0.001) but not mortality (p = 0.316).
Conclusions: While SG-RYGB is safe with a low complication rate, SG-RYGB was associated with a higher rate of serious complications compared to P-RYGB.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017068 | PMC |
| http://dx.doi.org/10.1007/s11695-023-06546-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Benign, but Ominous, Pseudotumor in the Post-Sleeve Gastrectomy Hiatal Hernia: A Case Series.
J Comput Assist Tomogr
November 2024
Massachusetts General Hospital, Department of Radiology Division of Abdominal Imaging, Boston, MA.
We have incidentally observed a finding not yet described in the literature, on both cross-sectional imaging and fluoroscopy, to correlate with increased obstructive symptoms in our post sleeve gastrectomy patients. This case series aims to show postsurgical imaging cases with the common underlying finding of a pseudotumor associated with hiatal herniae and obstructive symptoms. Because this clinical presentation may, in some cases, warrant postsurgical revision, knowledge of the imaging findings and their potential clinical significance is useful to radiologists who interpret routine cross-sectional imaging examinations as well as fluoroscopic evaluations of these post sleeve gastrectomy patients.
View Article and Find Full Text PDFCritical Time Points for Assessing Long-Term Clinical Response After Sleeve Gastrectomy-A Retrospective Study of Patients with 13-Year Follow-Up.
Obes Surg
January 2025
Division of Bariatric and Metabolic Surgery, University General Hospital of Patras, Patras, Greece.
Background: Weight loss after sleeve gastrectomy (SG) demonstrates significant diversity in the long term and the implicated mechanisms behind suboptimal clinical response (SCR) or recurrent weight gain (RWG) need to be scrutinized. This study retrospectively examines weight-loss trajectories, aiming to identify critical time points to optimize follow-up strategies and guide future prospective research.
Methods: This is a single-center, retrospective study of 104 patients that underwent SG.
Safety and cost of selective histopathological analysis for detecting cancer in surgical specimens: a systematic review.
ANZ J Surg
January 2025
Department of Surgery, The Univeristy of Adelaide, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Background: Due to limited healthcare resources, there is global incentive to maximize efficacy while minimizing patient harm. Given the low rate of cancer diagnoses made via routine histopathological analysis of surgical specimens, a selective approach has been proposed as a viable alternative. This systematic review aimed to evaluate effectiveness of cancer detection and costs with a selective approach.
View Article and Find Full Text PDFCentral Pancreatectomy as a Surgical Alternative for Parenchyma Preservation.
Cureus
December 2024
Department of Hepatobiliary and Pancreatic Surgery, Pontificia Universidad Católica de Chile, Santiago, CHL.
Pancreatoduodenectomy and distal pancreatectomy are standard treatments for various pancreatic pathologies. These procedures involve radical resection and a significant loss of pancreatic tissue, which can lead to exocrine and/or endocrine pancreatic insufficiency. In selected cases of benign tumors or those with low malignant potential, central pancreatectomy can be performed with acceptable morbidity and mortality rates.
View Article and Find Full Text PDFGhrelin-LEAP2 interactions along the stomach-liver axis.
Endocr J
December 2024
Forefront Research Center, Graduate School of Science, Osaka University, Osaka 560-0043, Japan.
Ghrelin produced in the stomach promotes food intake and GH secretion, and acts as an anabolic peptide during starvation. Ghrelin binds to the growth hormone secretagogue receptor, a G protein-coupled receptor (GPCR), whose high-resolution complex structures have been determined in the apo state and when bound to an antagonist. Anamorelin, a low-molecular-weight ghrelin agonist, has been launched in Japan for the treatment of cancer cachexia, and its therapeutic potential has attracted attention due to the various biological activities of ghrelin.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!