Gastric bypass revisional surgery: percentage total body weight loss differences among three different techniques

Suboptimal weight loss or weight regain may occur after Roux-en-Y gastric bypass (RYGB). For this reason, revisional surgery has gained increasing interest. We aimed to compare the percentage of total body weight loss (%TBWL) at one-year follow-up among three different techniques: Jejuno-jejunostomy distalization (JJD), Sleeve resection of the gastrojejunostomy and gastric pouch (SRGJP), and the combination of both (JJD + SRGJP).

This retrospective cohort study included all patients who underwent revisional surgery after RYGB (2020–2021). The cohort was stratified by the type of revisional technique performed. Postoperative bariatric outcomes and nutritional deficiencies were compared among groups.

A total of 78 patients underwent revisional surgery after RYGB: JJD was performed in 8 (10.3%), SRGJP in 34 (43.6%), and JJD + SRGJP in 36 (46.1%) patients. The most common indication for surgery was weight regain, in 72 (92.3%) patients. The median lengths of the BP limbs before and after distalization, were 50 cm (IQR 40–75 cm) and 175 cm (IQR 150–200 cm), respectively. The median length of the new common limb (NCL) and total alimentary limb length (TALL) were 277 cm (IQR 250–313 cm) and 400 cm (IQR 375–475 cm), respectively. Median percentage of total body weight loss (%TBWL) at one year was 15% (IQR 15—19%) for JJD, 20% (IQR 13—26%) for SRGJP, and 21% (IQR 15- 28%) for JJD + SRGJP (p = 0.40).

In this study, the combined procedure (JJD + SRGJP) exhibited higher %TBWL at one year, however no statistically significant difference was identified among the three techniques.