Revisional surgery in severe nutritional complications after bariatric surgical procedures: report of four cases from a single institution and review of the literature

ABSTRACT Introduction: bariatric surgery is currently the only treatment that leads to long-term and sustained weight loss decreased morbidity mortality in morbidly obese individuals. Roux-en-Y bypass causes by restricting food intake associated with reduced intestinal absorption, addition multiple endocrine satiogenic effects. Biliopancreatic diversion promotes mainly due poor absorption of nutrients ingested. Both procedures exclude parts gastrointestinal tract. Objective: describe four cases revisional after primary surgery, serious nutritional complications, review literature regarding this subject. Methods: a retrospective analysis patients Unicamps center database literatures were performed. Results: identified, 2 women men, mean age 48 years. The body mass index before was 23.7 kg/m2. Three underwent Scopinaro biliopancreatic diversion, onde patient gastric bypass. surgeries revision, conversion, reversion. One died. For 12 articles remained (11 case reports 1 series). Another five important original included. Conclusion: fortunately, revision rarely necessary, but when indicated it has increased morbidity, It can be reverion or conversion according severity