Conversion bariatric surgery after sleeve gastrectomy: results and resolution of comorbidities. Experience of 209 consecutive patients

Cirugia espanola Pub Date : 2026-07-01 Epub Date: 2026-03-19 DOI:10.1016/j.cireng.2026.800318

David Merino, Lucía Sobrino, Javier Osorio, Berta Pérez-Grau, Fernando Guerrero, Claudio Lazzara

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Abstract

Background

Sleeve gastrectomy (SG) has become the most frequently performed bariatric procedure worldwide, however a substantial proportion of patients ultimately require conversion surgery due to complications or suboptimal outcomes. Comprehensive data on the results of the various conversion procedures remain limited.

Objective

To evaluate the indications, surgical techniques, safety profile, comorbidity resolution, and effectiveness of conversion bariatric surgery after SG.

Methods

Retrospective analysis of 209 patients who underwent conversion surgery after SG at Bellvitge University Hospital between 2015 and 2024. Primary outcomes included weight-loss results, complication rates, and comorbidity resolution. Secondary outcomes included length of hospital stay and achievement of Textbook Outcome.

Results

Mean age was 48.1 ± 7.8 years. Median maximum BMI was 54.8 kg/m² (IQR 47.7–60.6). Indications were weight regain (55.5%), insufficient weight loss (32.5%), and GERD (12.0%). Conversion procedures included DS (48.3%), SADI-S (40.7%), and RYGB (11.0%). Overall complication rate was 7.2% with no mortality. Median total weight loss from maximum weight was 36.5% (IQR 27.9–45.0) and from pre-conversion was 14.0% (IQR 6.6–23.1 %). Hypertension prevalence decreased from 40.2% post-SG to 15.8% post-conversion (60.7% improvement). Dyslipidemia improved from 24.4% to 7.2% (70.6% improvement). Type 2 diabetes decreased from 25.4% to 11.5% (54.7% improvement). Obstructive sleep apnea decreased from 47.4% to 17.2% (63.6% improvement).

Conclusion

Conversion surgery after SG is safe and effective, achieving excellent outcomes. Hypoabsorptive procedures showed superior metabolic results while maintaining acceptable complication rates.

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套筒胃切除术后的转换减肥手术：结果和合并症的解决。209例连续患者的经验。

背景：袖式胃切除术（SG）已成为世界范围内最常用的减肥手术，然而，由于并发症或预后不佳，很大一部分患者最终需要进行转换手术。关于各种转换程序结果的全面数据仍然有限。目的：评价SG后转换减肥手术的适应证、手术技术、安全性、合并症的解决和有效性。方法：回顾性分析2015-2024年在Bellvitge大学医院接受SG术后转化手术的209例患者。主要结果包括减肥结果、并发症发生率和合并症的解决。次要结局包括住院时间和达到教科书结局。结果：平均年龄48.1±7.8岁。中位最大BMI为54.8 kg/m²（IQR为47.7-60.6）。适应症为体重恢复（55.5%），体重减轻不足（32.5%）和胃食管反流（12.0%）。转换程序包括DS（48.3%）、SADI-S（40.7%）和RYGB（11.0%）。总并发症发生率为7.2%，无死亡。从最大体重开始的中位总体重减少为36.5% (IQR为27.9-45.0)，从转换前开始的中位总体重减少为14.0% （IQR为6.6-23.1%）。高血压患病率从sg后的40.2%下降到转换后的15.8%（改善60.7%）。血脂异常从24.4%改善到7.2%（改善70.6%）。2型糖尿病从25.4%下降到11.5%（改善54.7%）。阻塞性睡眠呼吸暂停从47.4%下降到17.2%（改善63.6%）。结论：SG术后转归手术安全有效，效果良好。低吸收手术在维持可接受的并发症发生率的同时显示出优越的代谢结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Cirugia espanola

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