Revisional Gastric Bypass Is Inferior to Primary Gastric Bypass in Terms of Short- and Long-term Outcomes-Systematic Review and Meta-Analysis

Obes Surg. 2018 Jul;28(7):2083-2091. doi: 10.1007/s11695-018-3300-2.

Abstract

Purpose: Although Roux-en-Y gastric bypass (RYGB) is the main primary bariatric procedure, it has also been utilized as revisional bariatric surgery. Our aim is to compare revisionary gastric bypass with primary gastric bypass through systematic review with meta-analysis.

Methods: Available literature was searched for eligible studies up to December 2017. Inclusion criteria were reports on morbidity, %EWL, or diabetes remission. Secondary outcomes involved mortality, anastomotic leakage, operative time, and length of hospital stay. Random effect meta-analyses were undertaken.

Results: Initial search yielded 1164 references. Final meta-analysis involved 21 studies and revealed significant differences in terms of morbidity (RR1.54, p < 0.001) and EWL (WMD-19.9, p < 0.001). There were no differences in diabetes remission.

Conclusion: Revisionary RYGB has worse weight loss effect with greater morbidity rate than primary RYGB.

Keywords: Bariatric surgery; Gastric bypass; Obesity; RYGB; Revisional surgery.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Anastomotic Leak / surgery
  • Bariatric Surgery / adverse effects
  • Bariatric Surgery / methods
  • Bariatric Surgery / statistics & numerical data
  • Female
  • Gastric Bypass* / adverse effects
  • Gastric Bypass* / methods
  • Gastric Bypass* / statistics & numerical data
  • Humans
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Operative Time
  • Reoperation* / adverse effects
  • Reoperation* / methods
  • Reoperation* / statistics & numerical data
  • Treatment Outcome
  • Weight Loss