Background

Weight regain after Roux-En-Y gastric bypass and Laparoscopic Sleeve Gastrectomy presents a difficult clinical problem for bariatric surgeons. The Biliopancreatic Diversion with Duodenal Switch and Single anastomosis duodenal ileal bypass with Sleeve are two surgical options for conversion. We report on a single institution experience in these conversion procedures.

Methods

A retrospective chart review was performed on 15 patients who underwent conversion from LSG or RNYGB to biliopancreatic diversion with duodenal switch (BPD-DS) or single anastomosis duodeno-ileal bypass with sleeve (SADI-S) at a single institution between November 2016 and April 2023.

Results

Five patients underwent conversion from RNY to BPD-DS, seven underwent Sleeve gastrectomy to BPD-DS, two patients were converted from RNY to SADI-S and 1 patient underwent sleeve to SADI-S. At 1 month, 6 months, and 1 year mean excess body weight loss was 12%, 28% and 31% for the entire cohort. One patient required reoperation within thirty days for anastomotic leak. One patient developed an SMV thrombus that required readmission and anticoagulation.

Conclusions

Our short term follow-up data indicates that conversion of RNYGB or LSG to BPD-DS or SADI-S is a reasonable and safe salvage option in the setting of weight regain after bariatric surgery.