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Obesity Surgery
Published in: Obesity Surgery 4/2020

Open Access 01-04-2020 | Dyslipidemia | Original Contributions

Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?

Authors: Sama Abdulrazzaq, Wahiba Elhag, Walid El Ansari, Amjad Salah Mohammad, Davit Sargsyan, Moataz Bashah

Published in: Obesity Surgery | Issue 4/2020

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Abstract

Background

Revisional gastric bypass (R-RYGB) surgery is utilized for the management of inadequate weight loss or weight regain observed after some cases of bariatric surgeries. Data on the mid-term effectiveness of primary gastric bypass (P-RYGB) compared with R-RYGB (e.g., post sleeve gastrectomy/gastric banding) are controversial.

Methods

Retrospective chart review of all patients who received P-RYGB and R-RYGB (January 2011–June 2015) at our center. One hundred twenty patients who underwent P-RYGB and 34 R-RYGB who completed 18 months follow-up were included. We compared the effectiveness of P-RYGB with R-RYGB by assessing four anthropometric, two glycemic, and four lipid parameters, as well as the control of type 2 diabetes (T2DM), hypertension, dyslipidemia (remission, improvement, persistence, relapse, de novo), mortality and complications rates.

Results

A comparison of the effectiveness of P-RYGB with R-RYGB at 18 months revealed no significant differences in patients’ age, gender, and preoperative BMI between groups. However, patients who received P-RYGB had lower mean weight (P = 0.001) and BMI (P < 0.001), reflected by a higher mean delta BMI (P = 0.02), total weight loss percentage (TWL%) (P < 0.0001) and excess weight loss percentage (EWL%) (P < 0.0001). No differences in glycemic parameters, lipid profiles, control of T2DM, hypertension, and dyslipidemia were observed. No death is reported and complication rates were comparable.

Conclusions

Although R-RYGB effectively addressed inadequate weight loss, weight regain, and recurrence of comorbidities after restrictive bariatric surgery, R-RYGB resulted in inferior weight loss compared with P-RYGB. Neither procedure differed in their clinical control of T2DM, hypertension, and dyslipidemia. Both procedures exhibited comparable complication rates.
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Metadata
Title
Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?
Authors
Sama Abdulrazzaq
Wahiba Elhag
Walid El Ansari
Amjad Salah Mohammad
Davit Sargsyan
Moataz Bashah
Publication date
01-04-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04280-x

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