{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:56:48Z","timestamp":1792166208653,"version":"4.4.0"},"reference-count":93,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>As the use of metabolic and bariatric surgery (MBS) expands, clinicians increasingly encounter weight recurrence, suboptimal response, gastroesophageal reflux disease (GERD), nutritional problems, and procedure\u2010related complications. Revisional metabolic and bariatric surgery (RMBS) offers several corrective and conversion strategies, but outcomes vary by indication, prior anatomy, procedure, and patient characteristics. This narrative review summarizes current evidence on the benefits, risks, and clinical determinants of RMBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Evidence on indications, procedure selection, weight\u2010related and metabolic outcomes, GERD, complications, nutritional consequences, reoperation, mortality, and patient\u2010reported outcomes was narratively synthesized. Greater emphasis was placed on systematic reviews, meta\u2010analyses, comparative studies, registry analyses, and contemporary consensus guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>RMBS can provide additional weight reduction, improve selected obesity\u2010related comorbidities, and address complications of previous surgery. Roux\u2010en\u2010Y gastric bypass is particularly relevant when GERD is a major indication after sleeve gastrectomy, whereas more malabsorptive procedures may provide greater weight\u2010related benefit in selected patients at the cost of greater nutritional surveillance. Outcomes are influenced by the indication for revision, existing anatomy, nutritional and metabolic status, prior procedures, and procedural complexity. Quality of life improvement is possible but remains inconsistently reported. Pharmacological and endoscopic therapies may also serve as alternatives or adjuncts in selected patients with weight recurrence or suboptimal response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RMBS should be individualized rather than approached as a uniform treatment. Optimal management requires matching the intervention to the underlying indication, balancing expected benefits against procedural and nutritional risks, and providing multidisciplinary long\u2010term follow\u2010up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73315","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:42:08Z","timestamp":1790736128000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes, Risks, and Individualized Treatment Selection in Revisional Metabolic and Bariatric Surgery: A Narrative Review"],"prefix":"10.1002","volume":"9","author":[{"given":"Ramin","family":"Ebrahimian Jektaji","sequence":"first","affiliation":[{"name":"Department of Surgery, School of Medicine Guilan University of Medical Sciences Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahta","family":"Moghaddam Ahmadi","sequence":"additional","affiliation":[{"name":"Clinical Research Development Unit, Poursina Hospital Guilan University of Medical Sciences Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Shokrgozar","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine Guilan University of Medical Sciences Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9358-4775","authenticated-orcid":false,"given":"Moein","family":"Moghaddam Ahmadi","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine Guilan University of Medical Sciences Rasht Iran"},{"name":"Clinical Research Development Unit, Poursina Hospital Guilan University of Medical Sciences Rasht Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12294"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac071"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-015-1996-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2022.12.004"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2022.06.284"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2024.06.005"},{"key":"e_1_2_11_8_1","volume-title":"Obesity Surgery Guide for Patients","author":"Cemal K.","year":"2014"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-024-07196-3"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13113104"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0000000000001296"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.21037\/ales-23-15"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-018-3245-5"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.20517\/2574-1225.2021.137"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-024-07489-7"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2026.03.006"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-06937-1"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/wjs.12293"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-025-08325-2"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13930"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2017.04.031"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13122520"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2016150198"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43055-020-00157-7"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.20517\/2574-1225.2021.140"},{"key":"e_1_2_11_26_1","article-title":"Nutritional Deficiencies Before and After Bariatric Surgery in Low\u2010 and High\u2010Income Countries: Prevention and Treatment","volume":"16","author":"Kamal F. 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