Short-term outcome after Roux-en-Y gastric bypass for revision after failed sleeve gastrectomy versus De novo Roux-en-Y gastric bypass for bariatric patients

Abstract

Background: Revisional bariatric surgeries for weight regain are rising; however, they are considered as riskier and less efficient than primary bariatric procedures. This study aimed to study short-term postoperative outcomes after Roux-en-Y gastric bypass (RYGB) for revision after failed Sleeve gastrectomy versus primary RYGB in Bariatric patients regarding Weight loss, comorbidity resolution, Postoperative complications, hospital stay, mortality, and readmissions. Patients and Methods: This retrospective study was designed to compare early postoperative outcome between 2 groups of patients admitted to General Surgery Department, Tanta University Hospitals during the period from June 2018 and June 2023. Results: A total of 254 patients were included in the study, with 87 patients in revisional RYGB and 167 patients in primary RYGB. Groups were matched for age, sex, smoking, preoperative weight, and comorbidities. The duration of revisional RYGB was significantly longer than primary RYGB (201.1±49.85 vs. 161.9±45.05; P <0.001 ). Revisional RYGB patients stayed longer in the hospital (2.54±0.74 vs. 1.87±0.78; P <0.001 ). Total weight loss was significantly higher after 6 months and 1 year in Primary RYGB than group revisional RYGB ( P value<0.05 ). However, no differences were detected in postoperative complications, readmissions, reoperation rates, and comorbidity resolution. Conclusion: RYGB as revisional surgery after a previous Sleeve gastrectomy is a complex procedure that must be indicated with care. It is a safe technique, with postoperative complication rates similar to those of primary RYGB, while it may need longer operative