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Gastric Bypass as a Third Bariatric Procedure—Our Experience with 42 Cases

  • Nadav Nevo
  • Subhi Abu-Abeid
  • David Hazzan
  • Guy Lahat
  • Ido Nachmani
  • Shai Meron Eldar
Original Contributions

Abstract

Background

It is not uncommon to encounter patients seeking a third, fourth, or even fifth bariatric procedure. With higher expected complication rates and questionable patient benefit, the indication for multiple revisions is still in doubt. To evaluate the perioperative and post-operative outcomes of patients undergoing gastric bypass after two previous bariatric surgeries or more.

Methods

We identified all patients that underwent gastric bypass following at least 2 previous bariatric surgeries. We looked at patient demographics, previous bariatric surgeries, pre-operative body mass index (BMI) and obesity-related co-morbidities, perioperative complications, length of stay (LOS), re-admissions and re-operations, percentage of excess weight loss, and resolution or improvement in comorbidities.

Results

Forty-two patients met the inclusion criteria, the majority being females (31, 73.8%). Average age was 45.6 years (range 27–62), average weight and BMI was 116 kg (range 75–175 kg) and 41.1 kg/m2 (range 25.6–58.7 kg/m2), respectively. Thirty-two patients had two previous bariatric surgeries (73.8%), and 10 patients had 3 former bariatric surgeries (23.8%), and for one patient, this was the fifth bariatric procedure (2.4%). Mean LOS was 10 days (range 2–56 days). Eight patients (19%) needed re-admission and 5 (11.9%) needed re-operation. At a median follow up of 48 months (range 7–99 months), the average BMI was 34.5 kg/m2 (range 23.7–55.1 kg/m2) reflecting an excess BMI loss of 43.3%.

Conclusions

Gastric bypass as a third or more bariatric procedure is effective yet associated with high complication rates, re-admissions, and re-operations.

Keywords

Bariatric surgery Revisional bariatric surgery Failed bariatric surgery, weight loss failure Weight regain 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval Statement

For this type of study, formal consent is not required.

Informed Consent Statement

Does not apply.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.General Surgery DivisionThe Tel-Aviv Sourasky Medical CenterTel AvivIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Bariatric Surgery UnitThe Tel-Aviv Sourasky Medical CenterTel AvivIsrael
  4. 4.General Surgery Department CSheba Medical CenterRamat GanIsrael

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