Revisional bariatric surgery for failed restrictive procedures

Brian A. Coakley, Clifford Deveney, Donn Spight, Sarah K. Thompson, David Le, Blair A. Jobe, Bruce Wolfe, Donald McConnell, Robert W. O'Rourke

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background: Revisional bariatric surgery is increasing in frequency, but the morbidity and efficacy have not been well defined. The primary aim of this study was to determine the clinical efficacy with respect to weight loss, and associated morbidity, of revisional bariatric surgery in an academic university hospital bariatric surgery program. Methods: A retrospective review of all patients who underwent revisional bariatric surgery for failed primary restrictive procedures, including gastroplasty and gastric bypass, but not including gastric banding or malabsorptive procedures, during a 10-year period at a single university hospital was performed. The perioperative morbidity and long-term weight loss and clinical results were determined from the medical charts. Results: A total of 41 patients met the inclusion criteria. The primary bariatric procedures included vertical banded gastroplasty in 20 and Roux-en-Y gastric bypass in 21. The indications for revisional surgery included poor weight loss, weight regain, and various technical problems, including anastomotic stenosis and ulcer. The major morbidity rate was 17%. No patients died. The weight loss results varied depending on the indication for the revisional surgery and reoperative solution applied. The resolution of technical problems was achieved in all patients. Conclusion: Revisional bariatric surgery can be performed with minimal mortality, albeit significant morbidity. The efficacy with respect to weight loss appeared acceptable, although the results were not as good as those after primary bariatric surgery. The analysis of patient subsets stratified by surgical history and revisional strategy provided important insights into the mechanisms of failure and efficacy of different revisional strategies.

Original languageEnglish (US)
Pages (from-to)581-586
Number of pages6
JournalSurgery for Obesity and Related Diseases
Volume4
Issue number5
DOIs
StatePublished - Sep 2008

Fingerprint

Bariatric Surgery
Weight Loss
Morbidity
Gastroplasty
Gastric Bypass
Bariatrics
Ulcer
Stomach
Pathologic Constriction
History
Weights and Measures
Mortality

Keywords

  • Bariatric surgery
  • Gastric bypass
  • Restrictive procedures
  • Revisional surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Revisional bariatric surgery for failed restrictive procedures. / Coakley, Brian A.; Deveney, Clifford; Spight, Donn; Thompson, Sarah K.; Le, David; Jobe, Blair A.; Wolfe, Bruce; McConnell, Donald; O'Rourke, Robert W.

In: Surgery for Obesity and Related Diseases, Vol. 4, No. 5, 09.2008, p. 581-586.

Research output: Contribution to journalArticle

Coakley, Brian A. ; Deveney, Clifford ; Spight, Donn ; Thompson, Sarah K. ; Le, David ; Jobe, Blair A. ; Wolfe, Bruce ; McConnell, Donald ; O'Rourke, Robert W. / Revisional bariatric surgery for failed restrictive procedures. In: Surgery for Obesity and Related Diseases. 2008 ; Vol. 4, No. 5. pp. 581-586.
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