EFFECT OF REVISIONAL BARIATRIC SURGERY ON WEIGHT-LOSS AND FREQUENCY OF COMPLICATIONS

Background: The relative risks and effectiveness of primary and revisi on operations done to produce weight loss are of interest both from a patient care and an economic perspective. The possibility that patient s requiring revision surgery comprise a treatment resistant subgroup w ho are more likely to have post-operative complications is a valid con cern. Methods: The records of all patients having bariatric procedures since January of 1970 were evaluated for weight loss and complication s. Results: Most revisions were from jejunoileal bypass or a gastric r estrictive procedure. Early complications were significantly more comm on following revision surgery (19%) than after primary procedures (6%) , although late and combined early and late complication rates were si milar. Operative mortality was lower following primary procedures (2/3 82) than revisions (1/75). Cholecystectomy was a common sequela follow ing primary procedures but did not occur after revision procedures. Re gardless of surgical category, weight loss after revision was equivale nt to weight loss after primary procedures. Conclusions: Weight loss f ollowing revisional bariatric surgery is equivalent to weight loss fol lowing a primary operation of the same type: Although mortality and ea rly complications are more common after revisional bariatric surgery, the frequency of late complications is not different. In all groups wo und infections and hernias were relatively common complications and ch olecystectomies are rare after revisional bariatric operations.