TOPLINE:

Revisional bariatric surgery procedures were associated with significantly higher odds of severe complications than primary procedures.

METHODOLOGY:

• Researchers conducted an observational study in France between 2016 and 2022 to determine the revisional rate of bariatric surgery and risk factors associated with secondary bariatric surgeries.
• They analysed data of 284,271 procedures performed on 279,285 adult patients.
• Patients who underwent primary surgery served as a reference group, and a revisional surgery group was further categorised as those who underwent revisional surgery following adjustable gastric band, revisional surgery following sleeve gastrectomy, or revisional surgery following gastric bypass.
• The primary outcome was the rate of severe complications (Clavien-Dindo grade ≥ 3) occurring within 90 days post-surgery.
• Other outcomes were rates of abdominal sepsis (gastric leaks and peritonitis) and bleeding (gastrointestinal haemorrhage, haemoperitoneum, or haemorrhagic gastric ulcer).

TAKEAWAY:

• Overall, the rate of revisional procedures was 12.8%. Patients who underwent revisional bariatric surgery were older and predominantly women (P < .001 for both).
• Higher rates of severe complications were noted for revisional procedures (3.4% for revisional procedures after adjustable gastric band, 6.9% for revisional procedures after sleeve gastrectomy, and 9.0% for revisional procedures after gastric bypass) than for primary procedures (2.5%; P < .001).
• Gastric bypass was more commonly performed as a revisional procedure. Overall revisional surgery was associated with higher odds of severe complications (odds ratio [OR], 1.58; P < .001), and the risk was highest with revisional procedures after gastric bypass surgery (OR, 2.70; P < .001).
• Patients who underwent revisional sleeve gastrectomy experienced more severe complications than those who underwent primary sleeve gastrectomy (after adjustable gastric band: OR, 1.25; P < .001 or after sleeve gastrectomy: OR, 2.87; P < .001). Similarly, increased odds of severe complications were noted for those who underwent gastric bypass after adjustable gastric band or sleeve gastrectomy.

IN PRACTICE:

"[The study] findings underscore the importance of careful patient selection through preoperative assessment and personalized postoperative management to reduce risks and optimize outcomes in this population," the authors of the study wrote.

SOURCE:

This study was led by A. Lazzati, Avicenne Hospital, Inria, Paris, France. It was published online on February 02, 2026, in the International Journal of Obesity.

LIMITATIONS:

Weight‑loss or comorbidity outcomes for the effectiveness of bariatric surgery were not assessed. Revisions done for non‑weight indications may be miscoded as non‑bariatric, potentially undercounting true revision rates. Specific procedure codes for newer techniques were not included, which may have affected outcomes for emerging procedures.

DISCLOSURES:

This study did not report any specific funding source. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.