Review articleSystematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force☆
Section snippets
Evidence search strategy
MEDLINE 1996–present was queried for the following terms: “bariatrics/ or *bariatric surgery” OR “gastric bypass/ or gastroplasty/” OR “band/ banding” OR “anastomosis, roux-en-y/ or biliopancreatic diversion/ or gastrectomy/” AND “revis$.mp” OR “conver$.mp.” OR “revers$.mp.” OR “fail$.mp.” OR “Reoperation/ reop$.mp.” OR “redo / redo” OR “regain.mp. or Weight Gain/”. The search was limited to articles in the English language with human patients.
A task force comprised of private practice and
I. Treatment of insufficient weight loss or weight regain after bariatric surgery
While the majority of bariatric patients do achieve successful outcomes after their primary operation, the patients who present with insufficient weight loss, continued co-morbid disease, or weight regain after bariatric surgery represent a challenging population. This group of bariatric patients may benefit from additional surgical therapy to treat their obesity and should be thoroughly evaluated by a multidisciplinary program to determine the potential causes for their poor response. This
RYGB
Conversion. Indications for conversion of RYGB to another procedure are primarily related to weight regain or recurrence of co-morbid disease, but rare metabolic derangements of the primary operation (refractory neuroglycopenia, recalcitrant hypocalcemia with associated hypoparathyroidism, and severe malnutrition) may require conversion of RYGB to SG or BPD/DS, or original anatomy [86], [87]. These reports demonstrate technical feasibility and short-term results of these 1- or 2-stage
Conclusions and future directions
The current evidence regarding reoperative bariatric surgery includes a diverse group of patient populations and procedures. The majority of the studies are single institution case series reporting short- and medium-term outcomes after reoperative procedures. The reported outcomes after reoperative bariatric surgery are generally favorable and demonstrate that additional weight loss and co-morbidity reduction is achieved with additional therapy. The risks of reoperative bariatric surgery are
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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This project was supported by an unrestricted educational grant by Covidien.