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Erschienen in: Obesity Surgery 9/2016

08.06.2016 | Review Article

Re-operations after Secondary Bariatric Surgery: a Systematic Review

verfasst von: Alexandr Kuzminov, Andrew J. Palmer, Stephen Wilkinson, Bekkhan Khatsiev, Alison J. Venn

Erschienen in: Obesity Surgery | Ausgabe 9/2016

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Abstract

This paper reviews reoperations rates for short- and long-term complications following secondary bariatric procedures and need for further bariatric surgery. The search revealed 28 papers (1317 secondary cases) following at least 75 % of patients for 12 months or more. For adjustable gastric banding (AGB), rebanding had higher re-revisional rates than conversions into other procedures. Conversion of AGB to Roux-en-Y gastric bypass had the highest number of short- (10.7 %) and long-term (22.0 %) complications. We estimated 194 additional reoperations per 1000 patients having a secondary procedure, 8.8 % needing tertiary surgery. Despite being poorly reported, risks of reoperations for long-term complications and tertiary bariatric surgery are higher than usually reported risks of short-term complications and should be taken into account when choosing a secondary bariatric procedure and for economic evaluations.
Literatur
1.
Zurück zum Zitat Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;347:f5934.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Courcoulas AP, Yanovski SZ, Bonds D, Eggerman TL, Horlick M, Staten MA, et al. Long-term outcomes of bariatric surgery: a national institutes of health symposium. JAMA Surg 2014. Courcoulas AP, Yanovski SZ, Bonds D, Eggerman TL, Horlick M, Staten MA, et al. Long-term outcomes of bariatric surgery: a national institutes of health symposium. JAMA Surg 2014.
3.
4.
Zurück zum Zitat Himpens J, Cadiere GB, Bazi M, Vouche M, Cadiere B, Dapri G. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146(7):802–7.CrossRefPubMed Himpens J, Cadiere GB, Bazi M, Vouche M, Cadiere B, Dapri G. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146(7):802–7.CrossRefPubMed
5.
Zurück zum Zitat Lanthaler M, Aigner F, Kinzl J, Sieb M, Cakar-Beck F, Nehoda H. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20(8):1078–85.CrossRefPubMed Lanthaler M, Aigner F, Kinzl J, Sieb M, Cakar-Beck F, Nehoda H. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20(8):1078–85.CrossRefPubMed
6.
Zurück zum Zitat International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). First IFSO Global Registry Report. Dendrite Clinical Systems: 2014, 140 p. International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). First IFSO Global Registry Report. Dendrite Clinical Systems: 2014, 140 p.
7.
Zurück zum Zitat Buchwald H. Revisional metabolic/bariatric surgery: a moral obligation. Obes Surg. 2014. Buchwald H. Revisional metabolic/bariatric surgery: a moral obligation. Obes Surg. 2014.
9.
Zurück zum Zitat Hoerger TJ, Zhang P, Segel JE, Kahn HS, Barker LE, Couper S. Cost-effectiveness ofbariatric surgery for severely obese adults with diabetes. Diabetes Care. 2010;33(9):1933–9.CrossRefPubMedPubMedCentral Hoerger TJ, Zhang P, Segel JE, Kahn HS, Barker LE, Couper S. Cost-effectiveness ofbariatric surgery for severely obese adults with diabetes. Diabetes Care. 2010;33(9):1933–9.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Maklin S, Malmivaara A, Linna M, Victorzon M, Koivukangas V, Sintonen H. Cost-utility of bariatric surgery for morbid obesity in Finland. Br J Surg. 2011;98(10):1422–9.CrossRefPubMed Maklin S, Malmivaara A, Linna M, Victorzon M, Koivukangas V, Sintonen H. Cost-utility of bariatric surgery for morbid obesity in Finland. Br J Surg. 2011;98(10):1422–9.CrossRefPubMed
11.
Zurück zum Zitat Keating CL, Dixon JB, Moodie ML, Peeters A, Bulfone L, Maglianno DJ, et al. Cost-effectiveness of surgically induced weight loss for the management of type 2 diabetes: modeled lifetime analysis. Diabetes Care. 2009;32(4):567–74.CrossRefPubMedPubMedCentral Keating CL, Dixon JB, Moodie ML, Peeters A, Bulfone L, Maglianno DJ, et al. Cost-effectiveness of surgically induced weight loss for the management of type 2 diabetes: modeled lifetime analysis. Diabetes Care. 2009;32(4):567–74.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Ee E, Nottle PD. Outcomes of revision laparoscopic gastric banding: a retrospective study. ANZ J Surg. 2013;83(7–8):571–4.CrossRefPubMed Ee E, Nottle PD. Outcomes of revision laparoscopic gastric banding: a retrospective study. ANZ J Surg. 2013;83(7–8):571–4.CrossRefPubMed
13.
Zurück zum Zitat Muller MK, Attigah N, Wildi S, Hahnloser D, Hauser R, Clavien PA, et al. High secondary failure rate of rebanding after failed gastric banding. Surg Endosc. 2008;22(2):448–53.CrossRefPubMed Muller MK, Attigah N, Wildi S, Hahnloser D, Hauser R, Clavien PA, et al. High secondary failure rate of rebanding after failed gastric banding. Surg Endosc. 2008;22(2):448–53.CrossRefPubMed
14.
Zurück zum Zitat Wheeler E, Prettyman A, Lenhard MJ, Tran K. Adherence to outpatient program postoperative appointments after bariatric surgery. Surg Obes Relat Dis. 2008;4(4):515–20.CrossRefPubMed Wheeler E, Prettyman A, Lenhard MJ, Tran K. Adherence to outpatient program postoperative appointments after bariatric surgery. Surg Obes Relat Dis. 2008;4(4):515–20.CrossRefPubMed
15.
Zurück zum Zitat Aarts EO, Dogan K, Koehestanie P, Janssen IM, Berends FJ. What happens after gastric band removal without additional bariatric surgery? Surg Obes Relat Dis. 2013. Aarts EO, Dogan K, Koehestanie P, Janssen IM, Berends FJ. What happens after gastric band removal without additional bariatric surgery? Surg Obes Relat Dis. 2013.
16.
Zurück zum Zitat Jan JC, Hong D, Bardaro SJ, July LV, Patterson EJ. Comparative study between laparoscopic adjustable gastric banding and laparoscopic gastric bypass: single-institution, 5-year experience in bariatric surgery. Surg Obes Relat Dis. 2007;3(1):42–50 .discussion -1CrossRefPubMed Jan JC, Hong D, Bardaro SJ, July LV, Patterson EJ. Comparative study between laparoscopic adjustable gastric banding and laparoscopic gastric bypass: single-institution, 5-year experience in bariatric surgery. Surg Obes Relat Dis. 2007;3(1):42–50 .discussion -1CrossRefPubMed
17.
Zurück zum Zitat Keidar A, Szold A, Carmon E, Blanc A, Abu-Abeid S. Band slippage after laparoscopic adjustable gastric banding: etiology and treatment. Surg Endosc. 2005;19(2):262–7.CrossRefPubMed Keidar A, Szold A, Carmon E, Blanc A, Abu-Abeid S. Band slippage after laparoscopic adjustable gastric banding: etiology and treatment. Surg Endosc. 2005;19(2):262–7.CrossRefPubMed
18.
Zurück zum Zitat Brolin RE, Cody RP. Adding malabsorption for weight loss failure after gastric bypass. Surg Endosc. 2007;21(11):1924–6.CrossRefPubMed Brolin RE, Cody RP. Adding malabsorption for weight loss failure after gastric bypass. Surg Endosc. 2007;21(11):1924–6.CrossRefPubMed
19.
Zurück zum Zitat Buchwald H. Revisional metabolic/bariatric surgery: a moral obligation. Obes Surg. 2015;25(3):547–9.CrossRefPubMed Buchwald H. Revisional metabolic/bariatric surgery: a moral obligation. Obes Surg. 2015;25(3):547–9.CrossRefPubMed
20.
Zurück zum Zitat Wenger M, Piec G, Branson R, Potoczna N, Horber FF, Steffen R. Salvage of gastric restriction following staple-line dehiscence after vertical banded gastroplasty by insertion of an adjustable gastric band. Obes Surg. 2005;15(2):216–22.CrossRefPubMed Wenger M, Piec G, Branson R, Potoczna N, Horber FF, Steffen R. Salvage of gastric restriction following staple-line dehiscence after vertical banded gastroplasty by insertion of an adjustable gastric band. Obes Surg. 2005;15(2):216–22.CrossRefPubMed
21.
Zurück zum Zitat Bueter M, Thalheimer A, Wierlemann A, Fein M. Reoperations after gastric banding: replacement or alternative procedures? Surg Endosc. 2009;23(2):334–40.CrossRefPubMed Bueter M, Thalheimer A, Wierlemann A, Fein M. Reoperations after gastric banding: replacement or alternative procedures? Surg Endosc. 2009;23(2):334–40.CrossRefPubMed
22.
Zurück zum Zitat Cordera F, Mai JL, Thompson GB, Sarr MG. Unsatisfactory weight loss after vertical banded gastroplasty: is conversion to Roux-en-Y gastric bypass successful? Surgery. 2004;136(4):731–7.CrossRefPubMed Cordera F, Mai JL, Thompson GB, Sarr MG. Unsatisfactory weight loss after vertical banded gastroplasty: is conversion to Roux-en-Y gastric bypass successful? Surgery. 2004;136(4):731–7.CrossRefPubMed
23.
Zurück zum Zitat Cusati D, Sarr M, Kendrick M, Que F, Swain JM. Refractory strictures after Roux-en-Y gastric bypass: operative management. Surg Obes Relat Dis. 2011;7(2):165–9.CrossRefPubMed Cusati D, Sarr M, Kendrick M, Que F, Swain JM. Refractory strictures after Roux-en-Y gastric bypass: operative management. Surg Obes Relat Dis. 2011;7(2):165–9.CrossRefPubMed
24.
Zurück zum Zitat Dapri G, Cadiere GB, Himpens J. Feasibility and technique of laparoscopic conversion of adjustable gastric banding to sleeve gastrectomy. Surg Obes Relat Dis. 2009;5(1):72–6.CrossRefPubMed Dapri G, Cadiere GB, Himpens J. Feasibility and technique of laparoscopic conversion of adjustable gastric banding to sleeve gastrectomy. Surg Obes Relat Dis. 2009;5(1):72–6.CrossRefPubMed
25.
Zurück zum Zitat Dapri G, Cadiere GB, Himpens J. Laparoscopic repeat sleeve gastrectomy versus duodenal switch after isolated sleeve gastrectomy for obesity. Surg Obes Relat Dis. 2011;7(1):38–43.CrossRefPubMed Dapri G, Cadiere GB, Himpens J. Laparoscopic repeat sleeve gastrectomy versus duodenal switch after isolated sleeve gastrectomy for obesity. Surg Obes Relat Dis. 2011;7(1):38–43.CrossRefPubMed
26.
Zurück zum Zitat Dargent J. Lap banding as a redo surgery: “restriction over restriction” may be a relevant bariatric strategy. Obes Surg. 2009;19(9):1243–9.CrossRefPubMed Dargent J. Lap banding as a redo surgery: “restriction over restriction” may be a relevant bariatric strategy. Obes Surg. 2009;19(9):1243–9.CrossRefPubMed
27.
Zurück zum Zitat Foletto M, Bernante P, Busetto L, Pomerri F, Vecchiato G, Prevedello L, et al. Laparoscopic gastric rebanding for slippage with pouch dilation: results on 29 consecutive patients. Obes Surg. 2008;18(9):1099–103.CrossRefPubMed Foletto M, Bernante P, Busetto L, Pomerri F, Vecchiato G, Prevedello L, et al. Laparoscopic gastric rebanding for slippage with pouch dilation: results on 29 consecutive patients. Obes Surg. 2008;18(9):1099–103.CrossRefPubMed
28.
Zurück zum Zitat Gagne DJ, Dovec E, Urbandt JE. Laparoscopic revision of vertical banded gastroplasty to Roux-en-Y gastric bypass: outcomes of 105 patients. Surg Obes Relat Dis. 2011;7(4):493–9.CrossRefPubMed Gagne DJ, Dovec E, Urbandt JE. Laparoscopic revision of vertical banded gastroplasty to Roux-en-Y gastric bypass: outcomes of 105 patients. Surg Obes Relat Dis. 2011;7(4):493–9.CrossRefPubMed
29.
Zurück zum Zitat Gautier T, Sarcher T, Contival N, Le Roux Y, Alves A. Indications and mid-term results of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2013;23(2):212–5.CrossRefPubMed Gautier T, Sarcher T, Contival N, Le Roux Y, Alves A. Indications and mid-term results of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2013;23(2):212–5.CrossRefPubMed
30.
Zurück zum Zitat Himpens J, De Schepper M, Dapri G. Laparoscopic conversion of adjustable gastric banding to sleeve gastrectomy: a feasibility study. Surg Laparosc Endosc Percutan Tech. 2010;20(3):162–5.CrossRefPubMed Himpens J, De Schepper M, Dapri G. Laparoscopic conversion of adjustable gastric banding to sleeve gastrectomy: a feasibility study. Surg Laparosc Endosc Percutan Tech. 2010;20(3):162–5.CrossRefPubMed
31.
Zurück zum Zitat Iannelli A, Schneck AS, Hebuterne X, Gugenheim J. Gastric pouch resizing for roux-en-Y gastric bypass failure in patients with a dilated pouch. Surg Obes Relat Dis. 2013;9(2):260–7.CrossRefPubMed Iannelli A, Schneck AS, Hebuterne X, Gugenheim J. Gastric pouch resizing for roux-en-Y gastric bypass failure in patients with a dilated pouch. Surg Obes Relat Dis. 2013;9(2):260–7.CrossRefPubMed
32.
Zurück zum Zitat Khan OA, Mansour S, Irukulla S, Reddy KM, Vasilikostas G, Wan AC. Sleeve gastrectomy for gastric band failures—a prospective study. Int J Surg. 2013;11(5):407–9.CrossRefPubMed Khan OA, Mansour S, Irukulla S, Reddy KM, Vasilikostas G, Wan AC. Sleeve gastrectomy for gastric band failures—a prospective study. Int J Surg. 2013;11(5):407–9.CrossRefPubMed
33.
Zurück zum Zitat Niville E, Dams A, Van Der Speeten K, Verhelst H. Results of lap rebanding procedures after lap-band removal for band erosion—a mid-term evaluation. Obes Surg. 2005;15(5):630–3.CrossRefPubMed Niville E, Dams A, Van Der Speeten K, Verhelst H. Results of lap rebanding procedures after lap-band removal for band erosion—a mid-term evaluation. Obes Surg. 2005;15(5):630–3.CrossRefPubMed
34.
Zurück zum Zitat Perathoner A, Zitt M, Lanthaler M, Pratschke J, Biebl M, Mittermair R. Long-term follow-up evaluation of revisional gastric bypass after failed adjustable gastric banding. Surg Endosc. 2013;27(11):4305–12.CrossRefPubMed Perathoner A, Zitt M, Lanthaler M, Pratschke J, Biebl M, Mittermair R. Long-term follow-up evaluation of revisional gastric bypass after failed adjustable gastric banding. Surg Endosc. 2013;27(11):4305–12.CrossRefPubMed
35.
Zurück zum Zitat Poyck PP, Polat F, Gouma DJ, Hesp WL. Is biliopancreatic diversion with duodenal switch a solution for patients after laparoscopic gastric banding failure? Surg Obes Relat Dis. 2012;8(4):393–9.CrossRefPubMed Poyck PP, Polat F, Gouma DJ, Hesp WL. Is biliopancreatic diversion with duodenal switch a solution for patients after laparoscopic gastric banding failure? Surg Obes Relat Dis. 2012;8(4):393–9.CrossRefPubMed
36.
Zurück zum Zitat Rawlins ML, Teel 2nd D, Hedgcorth K, Maguire JP. Revision of Roux-en-Y gastric bypass to distal bypass for failed weight loss. Surg Obes Relat Dis. 2011;7(1):45–9.CrossRefPubMed Rawlins ML, Teel 2nd D, Hedgcorth K, Maguire JP. Revision of Roux-en-Y gastric bypass to distal bypass for failed weight loss. Surg Obes Relat Dis. 2011;7(1):45–9.CrossRefPubMed
37.
Zurück zum Zitat Rebibo L, Fuks D, Verhaeghe P, Deguines JB, Dhahri A, Regimbeau JM. Repeat sleeve gastrectomy compared with primary sleeve gastrectomy: a single-center, matched case study. Obes Surg. 2012;22(12):1909–15.CrossRefPubMed Rebibo L, Fuks D, Verhaeghe P, Deguines JB, Dhahri A, Regimbeau JM. Repeat sleeve gastrectomy compared with primary sleeve gastrectomy: a single-center, matched case study. Obes Surg. 2012;22(12):1909–15.CrossRefPubMed
38.
Zurück zum Zitat Schouten R, van Dielen FM, Greve JW. Re-operation after laparoscopic adjustable gastric banding leads to a further decrease in BMI and obesity-related co-morbidities: results in 33 patients. Obes Surg. 2006;16(7):821–8.CrossRefPubMed Schouten R, van Dielen FM, Greve JW. Re-operation after laparoscopic adjustable gastric banding leads to a further decrease in BMI and obesity-related co-morbidities: results in 33 patients. Obes Surg. 2006;16(7):821–8.CrossRefPubMed
39.
Zurück zum Zitat Schouten R, van Dielen FM, van Gemert WG, Greve JW. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restoration of the positive effect on weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17(5):622–30.CrossRefPubMedPubMedCentral Schouten R, van Dielen FM, van Gemert WG, Greve JW. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restoration of the positive effect on weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17(5):622–30.CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Silecchia G, Rizzello M, De Angelis F, Raparelli L, Greco F, Perrotta N, et al. Laparoscopic sleeve gastrectomy as a revisional procedure for failed laparoscopic gastric banding with a "2-step approach": a multicenter study. Surg Obes Relat Dis 2013. Silecchia G, Rizzello M, De Angelis F, Raparelli L, Greco F, Perrotta N, et al. Laparoscopic sleeve gastrectomy as a revisional procedure for failed laparoscopic gastric banding with a "2-step approach": a multicenter study. Surg Obes Relat Dis 2013.
41.
Zurück zum Zitat te Riele WW, Sze YK, Wiezer MJ, van Ramshorst B. Conversion of failed laparoscopic gastric banding to gastric bypass as safe and effective as primary gastric bypass in morbidly obese patients. Surg Obes Relat Dis. 2008;4(6):735–9.CrossRef te Riele WW, Sze YK, Wiezer MJ, van Ramshorst B. Conversion of failed laparoscopic gastric banding to gastric bypass as safe and effective as primary gastric bypass in morbidly obese patients. Surg Obes Relat Dis. 2008;4(6):735–9.CrossRef
42.
Zurück zum Zitat Thill V, Khorassani R, Ngongang C, Van De Winkel N, Mendes da Costa P, Simoens CM. Laparoscopic gastric banding as revisional procedure to failed vertical gastroplasty. Obes Surg. 2009;19(11):1477–80.CrossRefPubMed Thill V, Khorassani R, Ngongang C, Van De Winkel N, Mendes da Costa P, Simoens CM. Laparoscopic gastric banding as revisional procedure to failed vertical gastroplasty. Obes Surg. 2009;19(11):1477–80.CrossRefPubMed
43.
Zurück zum Zitat Thoreson R, Cullen JJ. Indications and results of reversal of vertical banded gastroplasty (VBG). J Gastrointest Surg. 2008;12(11):2032–6.CrossRefPubMed Thoreson R, Cullen JJ. Indications and results of reversal of vertical banded gastroplasty (VBG). J Gastrointest Surg. 2008;12(11):2032–6.CrossRefPubMed
44.
Zurück zum Zitat Uglioni B, Wolnerhanssen B, Peters T, Christoffel-Courtin C, Kern B, Peterli R. Midterm results of primary vs. secondary laparoscopic sleeve gastrectomy (LSG) as an isolated operation. Obes Surg. 2009;19(4):401–6.CrossRefPubMed Uglioni B, Wolnerhanssen B, Peters T, Christoffel-Courtin C, Kern B, Peterli R. Midterm results of primary vs. secondary laparoscopic sleeve gastrectomy (LSG) as an isolated operation. Obes Surg. 2009;19(4):401–6.CrossRefPubMed
45.
Zurück zum Zitat van Wageningen B, Berends FJ, Van Ramshorst B, Janssen IF. Revision of failed laparoscopic adjustable gastric banding to Roux-en-Y gastric bypass. Obes Surg. 2006;16(2):137–41.CrossRefPubMed van Wageningen B, Berends FJ, Van Ramshorst B, Janssen IF. Revision of failed laparoscopic adjustable gastric banding to Roux-en-Y gastric bypass. Obes Surg. 2006;16(2):137–41.CrossRefPubMed
Metadaten
Titel
Re-operations after Secondary Bariatric Surgery: a Systematic Review
verfasst von
Alexandr Kuzminov
Andrew J. Palmer
Stephen Wilkinson
Bekkhan Khatsiev
Alison J. Venn
Publikationsdatum
08.06.2016
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 9/2016
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2252-7

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