Conversion to Roux‑en‑Y gastric bypass after sleeve gastrectomy: outcomes from a Middle Eastern cohort

Videosurgery and Other Miniinvasive Techniques · Published 2026-06-24 · DOI 10.20452/wiitm.2026.18036

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Authors (5)

Ashraf Maghrabi, Moaz W. Abulfaraj, Wisam Jamal, Suha Kaaki, Murad Aljiffry

Abstract

Introduction: Conversion from sleeve gastrectomy (SG) to Roux-en-Y gastric bypass (RYGB) is increasingly performed for refractory gastroesophageal reflux disease (GERD), recurrent weight gain, and anatomical complications, although outcome data from Middle Eastern centers remain limited. Aim: This study evaluated the effectiveness of conversion from SG to RYGB in a Middle Eastern cohort. Materials and methods: A retrospective review including 55 patients who underwent conversion from SG to RYGB at a tertiary center in Saudi Arabia between 2016 and 2024 was conducted. Indications for conversion included GERD, recurrent weight gain, suboptimal response to SG, strictures, and leaks. The assessed 1-year outcomes comprised body mass index (BMI), percentage of excess weight loss (%EWL), percentage of total weight loss, GERD symptom improvement, improvement in comorbidities, and postoperative complications. Laparoscopic (n = 40) and robotic (n = 15) approaches were descriptively compared. Results: The cohort included 32 women at a mean (SD) age of 46 (8) years. Mean (SD) pre-SG BMI in the study population was 42 (7.2) kg/m2. According to the main indications for conversion, at 1 year, mean (SD) BMI decreased to 24 (1.9) kg/m2 (GERD), 28 (3.3) kg/m2 (recurrent weight gain), and 27 (2.8) kg/m2 (GERD + recurrent weight gain; P <⁠0.001). Mean (SD) %EWL was 82%, 65%, and 67%, respectively. GERD symptoms improved in 85% of the patients. Type 2 diabetes remission occurred in 58%, hypertension improved in 72%, and complications occurred in 9.1% of the study cohort. Descriptive comparison of laparoscopic and robotic approaches showed similar outcomes, but should be interpreted with caution given the noncontemporaneous treatment periods. Conclusions: Conversion to RYGB after SG is effective for weight reduction and GERD symptom improvement, with acceptable morbidity rates.

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Publication details

Year
2026

Citation

Maghrabi, A., Abulfaraj, M., Jamal, W., et al. (2026). Conversion to Roux‑en‑Y gastric bypass after sleeve gastrectomy: outcomes from a Middle Eastern cohort. Videosurgery and Other Miniinvasive Techniques. https://doi.org/10.20452/wiitm.2026.18036

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