Weight Loss Outcomes and Comorbidity Resolution After Roux-en-Y Gastric Bypass for Failed Primary Adjustable Gastric Banding and Sleeve Gastrectomy.

Authors

Tamar Tsenteradze, Agustina A Pontecorvo, Steven P Bowers, Enrique F Elli

Published in

Obesity surgery. Oct 30, 2026. Epub Oct 30, 2026.

Abstract

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.
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.
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.
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.

PMID:
42961632
Bibliographic data and abstract were imported from PubMed on 31 Oct 2026.

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