Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass.

Journal Article (Journal Article)

INTRODUCTION: A subset of patients undergoing laparoscopic sleeve gastrectomy (SG) require eventual conversion to Roux-en-Y gastric bypass (RYGB) due to complications from SG or to enhance weight loss. The aim of this study is to characterize the indications for conversion and perioperative outcomes in a large cohort of these patients at a single institution. METHODS: Patients who underwent revisional surgery to convert SG to RYGB at our institution from January 2008 through January 2017 were retrospectively reviewed. RESULTS: Eighty-nine patients with previous SG underwent conversion to RYGB as part of a planned two-stage approach to gastric bypass (n = 36), for weight recidivism (n = 11), or for complications related to SG (n = 42). Complications from SG that warranted conversion included refractory GERD (40.5%), sleeve stenosis (31.0%), gastrocutaneous (16.7%), or gastropleural (7.1%) fistula, and gastric torsion (4.1%). The mean (SD) age was 47.2 years (11.4 years) and median BMI at the time of revision was 43.2 kg/m2. A laparoscopic approach was successfully completed in 76 patients (85.4%), with an additional of four completed robotically (4.5%). The median length of stay was 3 days. Twenty-eight patients (31.5%) had complications which included surgical site infection (20.2%), re-operation (6.7%), anastomotic stricture (3.4%), and one pulmonary embolism. There were no mortalities with a median follow-up of 15 months. CONCLUSIONS: Conversion of SG to RYGB is safe and technically feasible when performed for complications of SG or to enhance weight loss. This operation can be successfully performed laparoscopically with a low rate of conversion and reasonable complication profile.

Full Text

Duke Authors

Cited Authors

  • Landreneau, JP; Strong, AT; Rodriguez, JH; Aleassa, EM; Aminian, A; Brethauer, S; Schauer, PR; Kroh, MD

Published Date

  • December 2018

Published In

Volume / Issue

  • 28 / 12

Start / End Page

  • 3843 - 3850

PubMed ID

  • 30094577

Electronic International Standard Serial Number (EISSN)

  • 1708-0428

Digital Object Identifier (DOI)

  • 10.1007/s11695-018-3435-1

Language

  • eng

Conference Location

  • United States