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GERD Is Common Indication for Revisional Bariatric Surgery

Most patients requiring revision underwent sleeve gastrectomy as primary procedure; revisional surgery is most often RYGB

By Elana Gotkine HealthDay Reporter

FRIDAY, Dec. 1, 2023 (HealthDay News) — 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.

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