Background

The long-term studies with ten-year follow-up data have shown a failure rate of 15-35% following Roux-en-Y gastric bypass (RYGB). Aim The aim of the study was to evaluate the outcomes following laparoscopic duodenal switch (DS) surgery after failed RYGB. Setting: Single private institute, USA.

Methods

Data from 69 patients who underwent a laparoscopic conversion of failed RYGB to either Roux-en-Y DS (RYDS) or single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) from January 2012 through March 2019 by two surgeons were retrospectively analyzed. Regression analyses were performed for all follow-up weight-loss data

Results

Sixty-nine patients were included in the study. Of the 69 patients, nine patients underwent RYDS, and 60 patients underwent SADI-S. The average time to reoperation and weight regain following RYGB were 16.7 ± 10.2 years and 83.1 ± 49.3 lbs. The most common indications for revision were weight loss failure and weight regain. The mean age and BMI before revision DS were 50.5 ± 10 yrs. and 44.6 ± 9.5 kg/m2, respectively. The average length of stay, blood loss and operating time were 3.6 ± 2.7 days, 39 ± 3.9 cc, and 148 ± 46.3 mins, respectively. At five years, the patients lost an average BMI of 8.2 ± 7.4 kg/m2. The %EWL and %TWL were 52.6 ± 38.3 and 17.3 ± 16.8, respectively. The short- and long-term complication rates were 28.9% and 14.4%, respectively.

Conclusions

A laparoscopic revision from RYGB to DS is an effective weight-loss operation with long-term follow-up of 5 years.