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GERD is common indication for revisional bariatric surgery
For patients who have undergone bariatric surgery for gastroesophageal reflux disease (GERD), revision surgery is common and is mainly with a Roux-en-Y gastric bypass (RYGB), according to a study published online Oct. 31 in Surgical Endoscopy.
Sarah MacVicar, M.D., from the University of Alberta Hospital in Edmonton, Canada, and colleagues conducted a retrospective cohort study involving patients who required revisional surgery for GERD in 2020 using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program registry.
The researchers found that 4,412 patients required revisional surgery for GERD, representing 24 percent of all conversion procedures. Patients underwent sleeve gastrectomy as their original surgery in most cases (80.1 percent). For 84.4 percent of patients, the revisional surgery was RYGB. Overall, 11.9 percent of patients had major complications, and 0.23 percent of patients died within 30 days of revisional surgery.
In 31 and 38 patients (0.70 and 0.86 percent), respectively, anastomotic leak and gastrointestinal bleeding were the major complications. Operative length, preoperative antacid use, and RYGB were predictors of major complications in multivariable analyses.
"Future studies should be directed towards better shared decision-making with patients to minimize the burden of GERD-associated bariatric revisional procedures," the authors write.
More information: Sarah MacVicar et al, Revisional bariatric surgery for gastroesophageal reflux disease: characterizing patient and procedural factors and 30-day outcomes for a retrospective cohort of 4412 patients, Surgical Endoscopy (2023). DOI: 10.1007/s00464-023-10500-4
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