Re-operative bariatric surgeries continue to increase every year, and indications and outcomes have changed over time. The aim of this study is to assess trends and 30-day outcomes of elective re-operative metabolic and bariatric surgeries (MBS) between 2020-2023. National database, United States. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database from 2020-2023 was evaluated. Elective re-operations were included in the analysis while emergent and rare procedures were excluded. Comprehensive descriptive statistics were reported for pooled and stratified data. Preoperative variables and postoperative outcomes were compared. Of 828,481 surgeries, 90,410 elective re-operations occurred (10.9%) between 2020-2023. Sleeve gastrectomy (SG) re-operations were the most common. Of these, 39,265 (80.9%) were converted to Roux-en-Y Gastric Bypass (RYGB), and 5,331 (11%) to Duodenal Switch (DS)/Single Anastomosis Duodenal-Ileal bypass (SADI). Common indications for reoperation were weight recurrence/non-responders (53.7%) and gastroesophageal reflux (32.2%). Laparoscopic adjustable gastric band (LAGB) conversion to RYGB had higher complication rates than LAGB to SG (5.9% vs 3.4%). Conversion from SG to RYGB had higher complication rates compared with conversion to SADI or DS (5.9% vs 4.6% and 3.6%); however, SG to RYGB had lower rates of major complication (leak, deep space SSI, GI Bleeding). Re-operative bariatric surgery procedures have remained relatively stables over recent years. Sleeve gastrectomy is the most common primary MBS procedure as well as the most frequent requiring re-operation. While complication rates continue to be low for elective re-operative bariatric surgeries, comprehensive evaluation and counseling are vital for informed decision-making with patients. Objective assessment of indication and patient factors are necessary when choosing re-operative procedures.
Crnkovic et al. (Sun,) studied this question.