Obesity Surgery

, Volume 2, Issue 3, pp 245–252 | Cite as

Revisional Surgery for Failed Gastric Restrictive Procedures for Morbid Obesity

  • R A Hunter
  • J Mc K Watts
  • R E Dunstan
  • R Elmslie
  • P O'Brien
  • A Slavotinek
  • J Walsh
Article

As part of the Adelaide Obesity Surgery Study, we have reviewed all patients who have undergone revisional surgery. Of the 310 trial patients, 63 (20%) had revisions 1-69 (median 32) months following their original surgery--30% of all 105 gastrogastrostomy (GG) operations, 22% of 106 gastroplasty (GP) procedures, and 9% of 99 gastric bypasses (GB). Failure was due to stomal dilatation, 11% of all trial patients (71% of GG revisions), stomal stenosis, 6% (52% of GP revisions) and staple dehiscence, 4%. There was no mortality and a low hospital morbidity. Long-term success was only 23% (follow-up at least 3 years) and was achieved at considerable expense (3 reversals, 10 further revisions, 44 endoscopic procedures). Revisional surgery was successful in 45% of patients with stomal dilatation or dehiscence but in only 17% with stenosis. Overall, the most successful operation was revision of, or conversion to, gastric bypass (58% success rate), compared with gastroplasty (24%) and gastrogastrostomy (25%). Our long-term results following revisional surgery were disappointing, particularly for stenosis, and most failures followed revision to GG or GP. Roux-en-Y gastric bypass is the procedure of choice when considering revision.

Gastric bypass gastrogastrostomy gastroplasty morbid obesity reoperation results staple breakdown stomal dilatation stomal stenosis 

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Copyright information

© Springer 1992

Authors and Affiliations

  • R A Hunter
    • J Mc K Watts
      • R E Dunstan
        • R Elmslie
          • P O'Brien
            • A Slavotinek
              • J Walsh

                There are no affiliations available

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