Revision Bariatric Surgery: a Single-Center Case Series Analysis

This study assessed the feasibility and results of revisional bariatric surgery at a low-volume unit. This case series analysis was conducted from January 2017 to August 2020; the revision group comprised patients treated for weight regain (n = 6), insufficient weight loss (n = 3), and various complications (n = 6). Clinical characteristics and 30-day outcomes were assessed and compared with those of primary bariatric procedures (control, n = 173). A total of 8.0% (15/188) of patients underwent revisional procedures and have a significantly lower body mass index (33.1 vs. 39.9 kg/m²) and fewer comorbidities than controls. Gastric bypass was the most prevalent revisional procedure. A significantly longer operative duration (155 and 96 min; p < 0.001), longer length of stay (3.7 and 2.4 days), and higher 30-day complication rate (20.0% vs. 4.6%) were found in the revision group. There were no open conversions or mortality. A total of 5/6 weight regain patients achieved excessive weight loss > 50% versus only one insufficient weight loss patient who reached this goal. Complications, including marginal ulcer, fistula, and postsleeve gastrectomy stenosis, were alleviated after revision. Revisional surgery appears to be feasible and effective in a low-volume practice in patients with weight regain and complications after primary bariatric procedures; however, the benefits should be weighed against the risks. More robust evidence is required to support ongoing practice.