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Weight loss after Roux-en-Y gastric bypass and single anastomosis duodenoileostomy following failed sleeve gastrectomy

  • 2024 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Objective

While sleeve gastrectomy (SG) results in sustained weight loss for the majority of patients, some will experience inadequate weight loss or weight regain requiring revision. The objective of this study was to evaluate differences in weight loss over time between patients undergoing Roux-en-Y gastric bypass (RYGB) or single anastomosis duodenoileostomy (SADI) after SG.

Methods

We queried a single institution’s bariatrics registry to identify patients who underwent RYGB or SADI after previous SG over a three-year period. Demographics, operative characteristics, and post-operative complications were evaluated. Interval total body weight loss (TBWL) and excess body weight loss (EBWL) were calculated from available follow-ups within 2 years.

Results

We identified 124 patients who underwent conversion to RYGB (n = 61) or SADI (n = 63) following previous SG. There were no differences in sex, age, or medical comorbidities between groups. The median initial BMI was higher in the SADI group (44.9 vs. 41.9 for RYGB, p = 0.03) with greater excess body weight (56.7 vs. 64.3 kg, p = 0.04). The SADI group had a shorter median operative duration (157 vs. 182 min for RYGB, p < 0.01) and lower readmission rates (0 vs. 14.75%, p < 0.01). There was no difference in post-operative complications or need for rehydration therapy between the groups. Among 122 patients (98.4%) that had follow-up weights available, there were no differences in TBWL between groups. RYGB patients had a higher EBWL at 2, 3, and 6 months (p < 0.05 for all comparisons), but there were no differences between RYGB and SADI at 1 or 2 years.

Conclusions

Both RYGB and SADI conversions proved effective for further weight loss following failed SG at our academic center. While neither demonstrated clear superiority in long-term (> 1 year) weight loss, RYGB’s restrictive gastric pouch may explain its early weight loss advantage.

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Funding

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Authors and Affiliations

  1. Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Mail Location 0558, Cincinnati, OH, 45267-0558, USA

    Ryan Chae, Jenna Whitrock, Christopher Nguyen, Adam Price, Dennis Vaysburg, Joseph Imbus & Jennifer Colvin

Authors
  1. Ryan Chae
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  2. Jenna Whitrock
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  3. Christopher Nguyen
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  4. Adam Price
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  5. Dennis Vaysburg
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  6. Joseph Imbus
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  7. Jennifer Colvin
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Contributions

RC contributed to study design, acquisition of data, analysis, writing of the original draft, and critical revision of the manuscript. JW, CN, and AP contributed to data acquisition and critical revision of the manuscript. DV and JI contributed to interpretation of the results and critical revision of the manuscript. JC contributed to study design, analysis, interpretation of the results, and critical revision of the manuscript. All authors gave approval of the final manuscript prior to submission.

Corresponding author

Correspondence to Ryan Chae.

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Disclosures

The authors, Ryan Chae, Jenna Whitrock, Christopher Nguyen, Adam Price, Dennis Vaysburg, Joseph Imbus, and Jennifer Colvin, report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

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The results reported in this manuscript were presented at the 2024 SAGES Annual Meeting, April 20th, 2024, Cleveland, OH.

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Chae, R., Whitrock, J., Nguyen, C. et al. Weight loss after Roux-en-Y gastric bypass and single anastomosis duodenoileostomy following failed sleeve gastrectomy. Surg Endosc (2024). https://doi.org/10.1007/s00464-024-11055-8

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