Cirugia Espanola · Mar 19, 2026

Conversion bariatric surgery after sleeve gastrectomy: results and resolution of comorbidities. Experience of 209 consecutive patients

By Merino D, Sobrino L, Osorio J et al.

BACKGROUND: Sleeve gastrectomy (SG) has become the most frequently performed bariatric procedure worldwide, however a substantial proportion of patients ultimately require conversion surgery due to complications or suboptimal outcomes. Comprehensive data on the results of the various conversion procedures remain limited. OBJECTIVE: To evaluate the indications, surgical techniques, safety profile, comorbidity resolution, and effectiveness of conversion bariatric surgery after SG. METHODS: Retrospective analysis of 209 patients who underwent conversion surgery after SG at Bellvitge University Hospital between 2015 and 2024. Primary outcomes included weight-loss results, complication rates, and comorbidity resolution. Secondary outcomes included length of hospital stay and achievement of Textbook Outcome. RESULTS: Mean age was 48.1 ± 7.8 years. Median maximum BMI was 54.8 kg/m² (IQR 47.7-60.6). Indications were weight regain (55.5%), insufficient weight loss (32.5%), and GERD (12.0%). Conversion procedures included DS (48.3%), SADI-S (40.7%), and RYGB (11.0%). Overall complication rate was 7.2% with no mortality. Median total weight loss from maximum weight was 36.5% (IQR 27.9-45.0) and from pre-conversion was 14.0% (IQR 6.6-23.1 %). Hypertension prevalence decreased from 40.2% post-SG to 15.8% post-conversion (60.7% improvement). Dyslipidemia improved from 24.4% to 7.2% (70.6% improvement). Type 2 diabetes decreased from 25.4% to 11.5% (54.7% improvement). Obstructive sleep apnea decreased from 47.4% to 17.2% (63.6% improvement). CONCLUSION: Conversion surgery after SG is safe and effective, achieving excellent outcomes. Hypoabsorptive procedures showed superior metabolic results while maintaining acceptable complication rates.

doi.org/10.1016/j.cireng.2026.800318PubMed 41864458Interventions