Background

Bariatric surgery has been shown to produce the most predictable weight loss results, with laparoscopic sleeve gastrectomy(LSG) being the most performed procedure as of 2014. However, inadequate weight-loss may present the need for a revisional procedure. The aim of this study is to compare the efficacy of laparoscopic re-sleeve gastrectomy(LRSG) and laparoscopic Roux-en-Y gastric bypass(LRYGB) in attaining successful weight loss following LSG.

Methods

A retrospective analysis was performed on all patients who underwent LSG at Amiri Hospital from 2008-2018. A list was obtained of those who underwent revisional bariatric surgery after initial LSG, and their demographics were analyzed.

Results

A total of 2,858 patients underwent LSG, of which 84 patients(3%) underwent either a revisional rLRYG or LSG. 82% of the patients were female. The mean weight and BMI prior to LSG for the LRSG and rLRYGB patients were 136.7Kg and 49.9Kg/m2, and 133.9Kg and 50.5Kg/m2, respectively. The mean BMI showed a drop from 42.03 to 31.7(p=0.000) 1-year post-revisional surgery for the LRSG group, and 42.7 to 34.5 (p=0.000) for the rLRYGB group, correlating to an excess weight loss(EWL) of 61.7% and 48.1% respectively. At 3 years post-revisional, LRSG patients showed a decrease in BMI to 30.71(EWL=61.4%), while those that underwent rLRYGB showed an increase to 35.3(EWL=40.3%)

Conclusions

Revisional bariatric surgery is a safe and effective method for the management of failed primary LSG. LRSG patients tended to do better in the mid-term than those that underwent rLRYGB.