Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass

Joshua P. Landreneau, Andrew T. Strong, John H. Rodriguez, Essa M. Aleassa, Ali Aminian, Stacy Brethauer, Philip R. Schauer, Matthew D. Kroh

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)

Abstract

Introduction: A subset of patients undergoing laparoscopic sleeve gastrectomy (SG) require eventual conversion to Roux-en-Y gastric bypass (RYGB) due to complications from SG or to enhance weight loss. The aim of this study is to characterize the indications for conversion and perioperative outcomes in a large cohort of these patients at a single institution. Methods: Patients who underwent revisional surgery to convert SG to RYGB at our institution from January 2008 through January 2017 were retrospectively reviewed. Results: Eighty-nine patients with previous SG underwent conversion to RYGB as part of a planned two-stage approach to gastric bypass (n = 36), for weight recidivism (n = 11), or for complications related to SG (n = 42). Complications from SG that warranted conversion included refractory GERD (40.5%), sleeve stenosis (31.0%), gastrocutaneous (16.7%), or gastropleural (7.1%) fistula, and gastric torsion (4.1%). The mean (SD) age was 47.2 years (11.4 years) and median BMI at the time of revision was 43.2 kg/m2. A laparoscopic approach was successfully completed in 76 patients (85.4%), with an additional of four completed robotically (4.5%). The median length of stay was 3 days. Twenty-eight patients (31.5%) had complications which included surgical site infection (20.2%), re-operation (6.7%), anastomotic stricture (3.4%), and one pulmonary embolism. There were no mortalities with a median follow-up of 15 months. Conclusions: Conversion of SG to RYGB is safe and technically feasible when performed for complications of SG or to enhance weight loss. This operation can be successfully performed laparoscopically with a low rate of conversion and reasonable complication profile.

Original languageEnglish
Pages (from-to)3843-3850
Number of pages8
JournalObesity Surgery
Volume28
Issue number12
DOIs
Publication statusPublished - Dec 1 2018
Externally publishedYes

Keywords

  • Bariatric surgery
  • Laparoscopy
  • Revisional surgery
  • Roux-en-Y gastric bypass
  • Sleeve gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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