Evidence map›Paper›PMID 39466428›Full record

ArticleSurgical endoscopy2024

Is conversion to duodenal switch after Roux-en-Y gastric bypass safe? Short-term outcomes review.

William Law, Emily Ortega-Goddard, Marcoandrea Giorgi, Andrew Luhrs

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Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

William LawDepartment of Surgery, Brown University/The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02906, USA.ORCID 0000-0003-3142-989X
Emily Ortega-GoddardDepartment of Surgery, Brown University/The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02906, USA. emily.goddard-ortega@brownphysicians.org.
Marcoandrea GiorgiDepartment of Surgery, Brown University/The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02906, USA.
Andrew LuhrsDepartment of Surgery, Brown University/The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02906, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWeight regain after Roux-en-Y gastric bypass (RYGB) can be seen in approximately 20% of patients. Surgical management options include revision of RYGB and conversion to duodenal switch (DS). Using recently included revisional surgery variables in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, we compared the safety and efficacy of RYGB revision versus conversion to DS.

methodsAn analysis of the 2020 MBSAQIP Participant Use Data File (PUF) revealed 1421 patients who underwent revision of RYGB (n = 1255) or conversion from RYGB to DS (n = 166) for inadequate weight loss or weight regain. Patient characteristics, preoperative body mass index (BMI), operating room (OR) time, and 30-day complications were compared between groups.

resultsWhen compared with the revision RYGB group, the DS group had higher mean BMI (47.5 vs 42.7, p < 0.001) and longer operative time (209.1 vs 133.4 min, p < 0.001). DS had higher rates of any complication compared to revision RYGB (22.3 vs 5.58%, p < 0.001). DS had higher 30-day readmission rates (16.3 vs 5.50%, p < 0.001), reoperation within 30 days (9.04 vs 2.87%, p < 0.001), venous thromboembolism (VTE) (3.01 vs 0.08%, p < 0.001), intensive care unit (ICU) admission (8.43 vs 0.72%, p < 0.001), anastomotic leak (7.83 vs 0.40%, p < 0.001), surgical site occurrence (SSO) (11.5 vs 2.71%, p < 0.001), and death (0.60 vs 0%, p < 0.001).

conclusionThis short-term data suggests that conversion of RYGB to DS is associated with higher rates of postoperative complications when compared with revision of RYGB. Given the complexity of the procedure, it is best performed by experienced surgeons with careful consideration given to appropriate patient selection and only after extensive patient counseling on associated risks and complications.

Indexed as

Gastric BypassObesity, MorbidPostoperative ComplicationsReoperationAdultBody Mass IndexDuodenumFemaleHumansMaleMiddle AgedOperative TimePatient ReadmissionTreatment OutcomeWeight GainWeight LossBariatric surgeryRevisional bariatric surgeryRoux-en-Y gastric bypassSingle-anastomosis duodeno-ileostomyWeight loss surgeryWeight regain

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.