Outcome of pouch reduction for dilated stomach in patients with weight loss failure after laparoscopic sleeve gastrectomy

Background
Revisional surgery is increasing after different bariatric surgeries, especially after laparoscopic sleeve gastrectomy (LSG), where laparoscopic re-sleeve gastrectomy is a proposed option as one of the revisional surgeries. The aim of this study was to evaluate the outcome of weight loss results in patients who underwent revisional re-sleeve gastrectomy after LSG for weight loss failure with dilated stomach.
Patients and methods
This was a cohort prospective study conducted on 40 patients who underwent LSG and failed to lose weight effectively or experienced weight regain with either dilated stomach only or associated with presence of retained fundus and then were subjected to re-sleeve gastrectomy and were followed up for one year with correlation to their weight loss results. This study was conducted at the Bariatric Surgery Unit of Ain Shams University Hospitals starting from October 2020 till the end of October 2022.
Results
This study results concerning group A, which underwent re-sleeve gastrectomy after initial LSG with dilated stomach and associated with retained fundus, showed % of excess weight loss in the range of 5.3–18.3%, 9–58.4%, and 13.2–94.2% in 1, 6, and 12 months postoperatively, respectively. However, group B, which underwent re-sleeve gastrectomy after initial LSG with homogenously dilated stomach only, showed % of excess weight loss in the range of 7.2–20.7%, 8.9–56.7%, and 10.6–95.6% at 1, 6, and 12 months postoperatively, respectively. This study results concerning group A showed initial BMI and follow-up BMI in the range of 36.6–48.3, 34.9–45.6, 30.2–42.6, and 25.1–41.7 initially and in 1, 6, and 12 months postoperatively, respectively, whereas group B showed initial BMI and follow-up BMI in the range of 37.6–47.3, 35.1–45.3, 30.3–45, and 24.8–44.9 initially and at 1, 6, and 12 months postoperatively, respectively.
Conclusion
Re-sleeve gastrectomy is a safe and good surgical option for patients who underwent LSG and failed to lose weight effectively or experienced weight regain with either dilated stomach only or associated with presence of retained fundus, resulting in significant weight loss results after 1-year follow-up, without significant differences between the two groups.