Laparoscopic conversion of sleeve gastrectomy to one anastomosis gastric bypass for weight loss failure. Mid-term results

Background: Laparoscopic sleeve gastrectomy (SG) became the most performed surgical intervention for treating population with morbid obesity. However, revisional surgery after SG has been increasingly performed due to weight loss failure. We describe the results of a single surgeon’s experience with conversion of SG to one anastomosis gastric bypass (OAGB) in patients with previous SG and weight loss failure. The aim of the study is to analyze the short- and mid-term results of conversion of SG to OAGB for failure of weight loss. Methods: Conversion of SG to OAGB was performed in 77 patients from May 2010 to June 2018. Vertical resleeving of the gastric tube was done in all patients. A chart review was conducted to determine the weight loss mid-term results and the occurrence of postoperative complications. Results: Revisional surgery was completed by laparoscopy in all cases. The mean operative time was 42.0 ± 8.0 min, and mean blood loss was 56.8 ± 56.7 mL. A total complication rate of 3.9% was observed. Ninety-day mortality rate was 0%. Patients mean %EWL was 80.2 (36–128) at 12-month follow-up, mean percent total weight loss (%TWL) was 0.74 (range 0.03–1.8), and mean percent excess BMI loss (ëMIL) was 70.7%. At 24-month follow-up, mean %EWL was 84.1 (41–128), mean %TWL 0.79 (range 0.32–1.6), and mean ëMIL 79.9%. Conclusion: In patients with history of SG and weight loss failure, conversion from SG to OAGB is effective in terms of weight loss and has a low risk of surgical complications.