Weight Loss Outcomes and Comorbidity Resolution After Roux-en-Y Gastric Bypass for Failed Primary Adjustable Gastric Banding and Sleeve Gastrectomy
In brief
Reflux resolved in 83% after sleeve-to-bypass, versus 33% after band-to-bypass
In this retrospective study, 83% of patients converted from sleeve gastrectomy to gastric bypass had reflux resolution at 2 years, compared with 33% converted from gastric banding. Band-to-bypass patients lost more weight in unadjusted comparisons, but the operation type was not independently linked to weight loss; the findings come from one center and need further study.
- Journal
- Obesity surgery (Q1)
- Published
- 30 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Tamar Tsenteradze, Agustina A Pontecorvo, Steven P Bowers, Enrique F Elli
- PMID
- 42961632
- DOI
- 10.1007/s11695-026-08999-2
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 2 November 2026): Direct comparison of revisional bypass after banding versus sleeve
Abstract
INTRODUCTION: Roux-en-Y gastric bypass (RYGB) is the most common revisional bariatric procedure after failed adjustable gastric banding (AGB) or sleeve gastrectomy (SG). Outcomes may differ based on the index of operation and indication for revision. METHODS: We performed a retrospective cohort study of adults undergoing conversion to RYGB after AGB or SG between 2013 and 2024 at a tertiary center. Demographics, perioperative outcomes, complications, weight loss, and comorbidity resolution were analyzed. Multivariable regression analysis was performed to adjust for baseline differences, and an exploratory robotic subgroup analysis was conducted. RESULTS: A total of 155 patients were included (AGB-RYGB, n = 53; SG-RYGB, n = 102). Early complication rates were similar between groups (11.3% vs. 11.8%, p = 0.94), with no mortality. Late reintervention rates were higher in SG-RYGB in the overall cohort (16.7% vs. 5.7%, p = 0.04), although this difference was not maintained in an exploratory robotic subgroup analysis. Greater unadjusted weight loss was observed after AGB-RYGB, reaching significance at 24 months in the overall cohort (TBWL 22.2% vs. 16.8%, p < 0.01). Multivariable regression analysis adjusting for baseline differences demonstrated that revision pathway was not independently associated with postoperative weight loss. Gastroesophageal reflux disease (GERD) resolution was significantly higher after SG-RYGB at all time points (24 months: 83.1% vs. 33.3%, p < 0.01). Comorbidity resolution was otherwise comparable. CONCLUSION: Conversion to RYGB after AGB or SG is safe, with comparable short-term outcomes. SG-RYGB was associated with higher GERD resolution, while greater unadjusted weight loss was observed after AGB-RYGB. However, multivariable regression analysis did not identify revision pathway as an independent predictor of postoperative weight loss. Exploratory robotic subgroup analysis demonstrated attenuation of some observed differences between groups, but these findings warrant further investigation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.