Mirza Arshad Beg, Ck Huang.
Surgical result of revision of Laparoscopic Sleeve Gasterctomy to Roux En Y Gastric Bypass (study carried out in Body and Metabolic International Medical Centre, China Medical University Hospital, Taichung).
Pak J Surg Jan ;36(4):273-6.

Introduction: Laparoscopic sleeve gastrectomy has made its mark as a stand alone procedure. Ever since its inception in the late 80s as a first stage procedure for more complicated procedures, laparoscopic sleeve gasterctomy (LSG) has now been established as a stand alone only procedure for a majority of morbidly obese individuals. In the last few years it has managed to surpass the various other procedures and due to its less learning curve and easier performance with good results is being utilized and has gained popularity around the globe. The complication rates aft er LSG vary among studies from 0% to 18%, with a 30-day post-operative mortality ranging from 0%-0.4%. In these scenarios it is sometimes prudent to change or "revise " to another feasible procedure. Roux En Y as a stand-alone procedure has stood the test of time and is the most oft en used procedure for a revision of sleeve gastrectomy. There is a dearth of studies on the subject and this institutional data attempts at providing an overview of the practice with reference to our institution. Objectives: Review of revision of laparoscopic sleeve gastrectomy to roux en y gastric bypass in a high volume center Study design: Retrospective Cohort of prospectively analyzed data Setting: Body and metabolic International Medical Centre, China Medical University Hospital, Taichung. Subjects: Patients undergoing revision to LRYGB after sleeve gastrectomy Methods: Duration of study: 2007-2018(11 years) Results: From the time period 2007-2018 (11 years) a total of 1566 patients underwent laparoscopic sleeve gastrectomy. 24-patients underwent revision to Roux En Y procedure, making 1.53% of total laparoscopic sleeve gastrectomies done. Gender distribution among the patients was of 29.2% males and 70.8 % females. Time interval to revision was longest as 6 years and shortest was 1 week, the average being 3.7 years. Among the factors responsible for revision included GERD in 37.5% (n=9) weight regain in 25% (n=6),inadequate weight loss in 20.8% (n=5), and in 16.7% (n=4) it was due to miscellaneous issues like gastric tube twist, stricture, and leak. Conclusions: This study is a small attempt in sharing our experience and perhaps a sub group analysis and similar studies from other high volume centers may be helpful for further study.

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