Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Bariatric Surgery

Investigating the trend of revisional bariatric surgery, the complications, and associated risk factors in France

International Journal of Obesity volume 50, pages 647–653 (2026)Cite this article

Subjects

Abstract

Background

Metabolic and bariatric surgery (MBS) is a highly effective treatment for patients with obesity, with increasing prevalence in France. However, some patients require revisional MBS (RMBS) due to suboptimal initial response, recurrent weight gain, and correction of technique-related complications. Understanding the prevalence and risks associated with RMBS is essential for optimizing patient care.

Objective

This study aims to assess the rate of RMBS in France and to delineate the associated complications and risk factors.

Setting

France.

Methods

Using national discharge data from 2016 to 2022, this observational study compared morbidity and mortality rates between primary and RMBS. Patient demographics, comorbidities, and procedural details were analyzed. Major complications within 90 days post-surgery were assessed using logistic regression models adjusted for potential confounders.

Results

Among 284,271 bariatric procedures analyzed, the revision rate was 12.8%. Patients undergoing RMBS were older, predominantly female, and had more comorbidities compared to those undergoing primary procedures. RMBS were associated with significantly higher rates of severe complications (OR 1.58, 95% CI 1.49–1.68, p < 0.001), particularly after gastric bypass (GB) (OR 2.70, 95% CI 2.27–3.20). Subgroup analyses showed increased morbidity following revisional sleeve gastrectomy compared to primary procedures.

Conclusions

This study highlights a notable rate of RMBS in France, with evolving trends towards more complex revisions. RMBS are associated with increased morbidity, emphasizing the need for careful patient selection and enhanced postoperative management. Further research into surgical techniques, long-term pharmacological interventions, and surgeon expertise is warranted to optimize outcomes in this population.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Type and pourcentage of revision in France during the time.

Similar content being viewed by others

Data availability

All datasets on which the conclusions of the paper rely should be available to readers. The data is available at Nantes University Hospital.

References

  1. Fontbonne A, Currie A, Tounian P, Picot M-C, Foulatier O, Nedelcu M, et al. Prevalence of overweight and obesity in france: the 2020 Obepi-Roche study by the “Ligue Contre l’Obésité”. J Clin Med. 2023;12:925.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lazzati A, Bechet S, Jouma S, Paolino L, Jung C. Revision surgery after sleeve gastrectomy: a nationwide study with 10 years of follow-up. Surg Obes Relat Dis. 2020;16:1497–504.

    Article  PubMed  Google Scholar 

  3. Brown WA, Liem R, Al-Sabah S, Anvari M, Boza C, Cohenet V, et al. IFSO global registry collaboration. metabolic bariatric surgery across the IFSO chapters: key insights on the baseline patient demographics, procedure types, and mortality from the eighth IFSO global registry report. Obes Surg. 2024;34:1764–77.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mann JP, Jakes AD, Hayden JD, Barth J. Systematic review of definitions of failure in revisional bariatric surgery. Obes Surg. 2015;25:571–4.

    Article  PubMed  Google Scholar 

  5. Nasta AM, Goel R, Singhal R, Lemmens L, Baig S, Seki Y, et al. 30-day morbidity and mortality of revisional bariatric surgery - An international multi-centre collaborative (BROAD) study. Obes Res Clin Pract. 2024;18:195–200.

    Article  PubMed  Google Scholar 

  6. Moulis G, Lapeyre-Mestre M, Palmaro A, Pugnet G, Montastruc J-L, Sailler L. French health insurance databases: what interest for medical research? Revue Med Interne. 2015;36:411–7.

    Article  CAS  Google Scholar 

  7. Tuppin P, de Roquefeuil L, Weill A, Ricordeau P, Merlière Y. French national health insurance information system and the permanent beneficiaries sample. Rev Épidémiol Santé Publique. 2010;58:286–90.

    Article  CAS  PubMed  Google Scholar 

  8. Bousquet C, Souvignet J, Merabti T, Sadou E, Trombert B, Rodrigues J-M. Method for mapping the French CCAM terminology to the UMLS metathesaurus. Stud Health Technol Inform. 2012;180:164–8.

    PubMed  Google Scholar 

  9. Charlson ME, Carrozzino D, Guidi J, Patierno C. Charlson comorbidity index: a critical review of clinimetric properties. Psychother Psychosom. 2022;91:8–35.

    Article  PubMed  Google Scholar 

  10. Clapp B, Wynn M, Martyn C, Foster C, O’Dell M, Tyroch A. Longterm (7 or more years) outcomes of the sleeve gastrectomy: ameta-analysis. Surg Obes Relat Dis. 2018;14:741–7.

    Article  PubMed  Google Scholar 

  11. Felsenreich DM, Ladinig LM, Beckerhinn P, Sperker C, Schwameis K, Krebs M, et al. Update:10 years of sleeve gastrectomy—The first 103 patients. ObesSurg. 2018;28:3586–94.

    Google Scholar 

  12. Mahawar KK, Graham Y, Carr WRJ, Jennings N, Schroeder N, Balupuriet S, et al. Revisional Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review of comparative outcomes with respective primary procedures. Obes Surg. 2015;25:1271–80.

    Article  PubMed  Google Scholar 

  13. Axer S, Szabo E, Agerskov S, Näslund I. Predictive factors of complications in revisional gastric bypass surgery: results from the Scandinavian obesity surgery registry. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2019;15:2094–100.

    Article  Google Scholar 

  14. El Chaar M, Stoltzfus J, Melitics M, Claros L, Zeido A. 30-day outcomes of revisional bariatric stapling procedures: first report based on MBSAQIP data registry. Obes Surg. 2018;28:2233–40.

    Article  PubMed  Google Scholar 

  15. Pedziwiatr M, Malczak P, Wierdak M, Rubinkiewicz M, Pisarska M, Major P, et al. Revisional gastric bypass is inferior to primary gastric bypass in terms of short-and long-term outcomes-systematic review and meta-analysis. Obes Surg. 2018;28:2083–91.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Salman M, Salman M, Elewa A, Elsherbiny M, Tourkey M, Chikukuza S, et al. Outcomes of revisional surgery options after inadequate sleeve gastrectomy: a comprehensive network meta-analysis. World J Surg. 2024;48:2040–57.

    Article  PubMed  Google Scholar 

  17. Spurzem GJ, Broderick RC, Kunkel EK, Hollandsworth H, Sandler B, Jacobsen G, et al. Robotic bariatric surgery reduces morbidity for revisional gastric bypass when compared to laparoscopic: outcome of 8-year MBSAQIP analysis of over 40,000 cases. Surg Endosc. 2024;38:6294–304.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Redmond IP, Shukla AP, Aronne LJ. Use of weight loss medications in patients after bariatric surgery. Curr Obes Rep. 2021;10:81–9.

    Article  PubMed  Google Scholar 

  19. Miras AD, Pérez-Pevida B, Aldhwayan M, Kamocka A, McGlone E, Al-Najim W, et al. Adjunctive liraglutide treatment in patients with persistent or recurrent type 2 diabetes after metabolic surgery (GRAVITAS): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2019;7:549–59.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Digestive, Bariatric and Endocrine Surgery, Avicenne Hospital, Inria, Bobigny Franc, Sorbonne Paris Nord University, HeKA, Paris, France

    A. Lazzati & C. Tresallet

  2. Digestive Surgery Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France

    G. Guian

  3. Université Paris Est Créteil, Créteil, France

    G. Guian

  4. Chirurgie cancérologique, digestive et endocrinienne, Institut des maladies de l’appareil digestif (IMAD), CHU de Nantes, Nantes, France

    C. Blanchard

  5. CHU de Nantes, l’institut du Thorax, CNRS, Inserm, Nantes Université, Nantes, France

    C. Blanchard

Authors
  1. A. Lazzati
    View author publications

    Search author on:PubMed Google Scholar

  2. C. Tresallet
    View author publications

    Search author on:PubMed Google Scholar

  3. G. Guian
    View author publications

    Search author on:PubMed Google Scholar

  4. C. Blanchard
    View author publications

    Search author on:PubMed Google Scholar

Contributions

CB participated in conception and design, data acquisition and analysis, and manuscript redaction. AL participated in conception and design, in statistical analysis, and manuscript redaction. CT and GG participated in data acquisition and revised the manuscript critically for important intellectual content.

Corresponding author

Correspondence to C. Blanchard.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lazzati, A., Tresallet, C., Guian, G. et al. Investigating the trend of revisional bariatric surgery, the complications, and associated risk factors in France. Int J Obes 50, 647–653 (2026). https://doi.org/10.1038/s41366-025-01990-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41366-025-01990-4

Search

Advanced search

Quick links