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Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?
Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Doha, Qatar.
Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Doha, Qatar.
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar. (Individ och samhälle VIDSOC, Individual and Society)ORCID iD: 0000-0003-0961-1302
Departments of General Surgery, Hamad General Hospital, Doha, Qatar.
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2020 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 30, p. 1219-1229Article in journal (Refereed) Published
Abstract [en]

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 to R-RYGB (e.g., post sleeve gastrectomy or 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 and 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 and dyslipidemia in terms of remission, improvement, persistence, relapse and de novo. The current study also assessed mortality and complications rates. Results: There were no significant differences in the baseline characteristics of patients who received P-RYGB with those who received R-RYGB in terms of age, gender and preoperative BMI. However, at 18 months: a) 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), TWL%(P <0.0001) and EWL%(P < 0.0001); b) No differences were observed between the two patients groups in terms of glycemic parameters, lipid profiles, and control of T2DM, hypertension, and dyslipidemia; and, c) No deaths were reported among both patients groups, and complication rates were comparable. Conclusion: 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 to P-RYGB. There were no significant differences between the two procedures in terms of their clinical control of T2DM, hypertension and dyslipidemia. Both procedures exhibited comparable complication rates. 

Place, publisher, year, edition, pages
Springer, 2020. Vol. 30, p. 1219-1229
Keywords [en]
Dyslipidemia, Hypertension, Primary gastric bypass, Revisional Gastric bypass, Type 2 diabetes, Weight loss outcome
National Category
Surgery
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-18125DOI: 10.1007/s11695-019-04280-xISI: 000516090000001PubMedID: 31865551Scopus ID: 2-s2.0-85077172688OAI: oai:DiVA.org:his-18125DiVA, id: diva2:1384792
Available from: 2020-01-10 Created: 2020-01-10 Last updated: 2020-04-22Bibliographically approved

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El Ansari, Walid

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