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Introduction <p>As the prevalence of sleeve gastrectomy (SG) continues to rise each year, so does the number of patients requiring conversion&#xa0;to a hypoabsorptive procedure due to suboptimal results. While&#xa0;various types of bypass surgeries have been studied, available literature on transit bipartitions (TB) remains limited.</p> Methods <p>We conducted a retrospective analysis of patients who underwent conversion of SG to TB&#xa0;at our institution between November 1, 2017 and March 30, 2022. Three TB techniques were evaluated: one anastomosis sleeve-ileal TB (OATB), sleeve-ileal loop TB with Braun jejunoileostomy (B-TB), and TB with a Roux-en-Y formed small bowel short circuit (RYTB). Additional percentage of excess weight loss (%EWLadditional), percentage of total body weight loss (%TWL), and resolution of obesity-related comorbidities were the primary outcomes, while adverse effects were analyzed to assess the safety of each procedure.</p> Results <p>Of the 482 SG-to-TB conversions performed by March 2024, 171 patients with a complete follow-up (FU) of 2&#xa0;years were included and matched by sex, age, and Body Mass Index (BMI) at the time of conversion. The&#xa0;%EWLadditional for OATB, B-TB, and RYTB at 2 years FU&#xa0;was 50.1, 53.4 and 54.3, respectively, with no significant differences in weight loss outcomes over time. OATB patients experienced more long-term&#xa0;adverse effects and showed a higher rate of reoperation.</p> Conclusiuon <p>TB after SG is a feasible and effective revisional procedure for achieving&#xa0;further weight loss and managing obesity-realated&#xa0;comorbidities. OATB, however, may be associated with a higher risk of long-term&#xa0;complications compared to other TB techniques.</p>

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Conversion of sleeve gastrectomy to different types of bipartitions: OATB, B-TB, and RYTB—a retrospective single-center study

  • 期刊论文

  • 发表日期：

    2025年8月30日

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  • Vasiliki Christogianni,
  • Ashwini Rao,
  • Christian-Joern Halter,
  • Panagiotis Bemponis,
  • Mohanned Raed,
  • Osama E. Zaidi,
  • Martin Buesing,
  • Markus Reiser

摘要

Introduction

As the prevalence of sleeve gastrectomy (SG) continues to rise each year, so does the number of patients requiring conversion to a hypoabsorptive procedure due to suboptimal results. While various types of bypass surgeries have been studied, available literature on transit bipartitions (TB) remains limited.

Methods

We conducted a retrospective analysis of patients who underwent conversion of SG to TB at our institution between November 1, 2017 and March 30, 2022. Three TB techniques were evaluated: one anastomosis sleeve-ileal TB (OATB), sleeve-ileal loop TB with Braun jejunoileostomy (B-TB), and TB with a Roux-en-Y formed small bowel short circuit (RYTB). Additional percentage of excess weight loss (%EWLadditional), percentage of total body weight loss (%TWL), and resolution of obesity-related comorbidities were the primary outcomes, while adverse effects were analyzed to assess the safety of each procedure.

Results

Of the 482 SG-to-TB conversions performed by March 2024, 171 patients with a complete follow-up (FU) of 2 years were included and matched by sex, age, and Body Mass Index (BMI) at the time of conversion. The %EWLadditional for OATB, B-TB, and RYTB at 2 years FU was 50.1, 53.4 and 54.3, respectively, with no significant differences in weight loss outcomes over time. OATB patients experienced more long-term adverse effects and showed a higher rate of reoperation.

Conclusiuon

TB after SG is a feasible and effective revisional procedure for achieving further weight loss and managing obesity-realated comorbidities. OATB, however, may be associated with a higher risk of long-term complications compared to other TB techniques.