Conversion of gastric sleeve to Roux-en-Y gastric bypass: overall outcomes and predictors of below-average weight loss |
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| Affiliation: | 1. Department of Surgery, University Hospitals, Cleveland, Ohio;2. Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio;1. Department of Surgery, Texas Tech Paul Foster School of Medicine, El Paso, Texas;2. Department of Surgery, Mayo Clinic, Rochester, Minnesota;3. Department of Surgery, Mayo Clinic, Jacksonville, Florida;4. Department of Surgery, Indiana University, Indianapolis, Indiana;5. Department of Surgery, University of California Davis, Sacramento, California;6. Department of Surgery, Oregon Health and Science University, Portland, Oregon;1. Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana;2. Paul Foster School of Medicine, Texas Tech HSC, El Paso, Texas;3. Department of Surgery, University of California Davis, Sacramento, California;4. Department of Surgery, Mayo Clinic, Rochester, Minnesota;5. Department of Surgery, Mayo Clinic, Jacksonville, Florida;6. Department of Surgery, Oregon Health & Science University, Portland, Oregon;1. Division of Gastroenterology, University of Colorado School of Medicine, Aurora, CO;2. Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO;3. Department of Surgery, University of Colorado School of Medicine, Aurora, CO |
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| Abstract: | ![]()
BackgroundConversion of sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB) has been utilized to promote further weight loss, but results are variable in available literature.ObjectivesTo evaluate outcomes of SG to RYGB conversion for weight loss and to identify predictors of below-average weight loss.SettingUniversity-affiliated hospital, United States.MethodsChart review was performed of our patients who underwent SG to RYGB conversion from November 1, 2013, to November 1, 2020. Primary outcomes were below-average percent excess weight loss (%EWL) at 1 and 2 years. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for preconversion demographics to evaluate their relationship to the primary outcome.ResultsSixty-two patients underwent conversion from SG to RYGB with weight loss as a goal. One-year data was available for 47 patients. The average %EWL at 1 year was 41.5%. Twenty-six patients had below-average %EWL at 1 year. Interval to conversion <2 years (OR = 4.41, 95% CI [1.28,15.17], P = .019) and preconversion body mass index (BMI) >40 (OR = 4.00, 95% CI [1.17,13.73], P = .028) were statistically significant predictors of below-average 1-year %EWL. Two-year data was available for 36 patients. The average %EWL at 2 years was 30.8%. Seventeen patients had below-average %EWL at 2 years. Evaluated demographics were not statistically significant predictors of below-average 2-year %EWL.ConclusionsFollowing SG to RYGB conversion, %EWL outcomes are lower at 1 year (41.5%) and 2 years (30.8%) than reported values for primary RYGB. Interval to conversion <2 years and preconversion BMI >40 are predictors of below-average 1-year weight loss after conversion. |
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| Keywords: | Conversion Revision Sleeve gastrectomy Roux-en-Y Gastric bypass Weight loss |
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