{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:57:05Z","timestamp":1790517425537,"version":"4.1.0"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic & Advanced Surgical Techniques"],"abstract":"\n Background:<\/jats:title>\n Recurrent weight gain after Roux-en-Y gastric bypass (RYGB) has become increasingly common. This study aimed to compare short-term surgical outcomes between patients undergoing Limb Lengthening (LL) versus Biliopancreatic Diversion with Duodenal Switch (BPD\/D) after RYGB.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A retrospective analysis of the MBSAQIP database (2020\u20132023) was performed, including patients that underwent revisional surgery with LL or BPD\/DS following RYGB. Thirty-day postoperative outcomes including overall postoperative complications (OPC) and unplanned health care utilization (UHCU), were analyzed. A multivariable logistic regression analysis and subgroup analysis were used to assessed for Bias.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 1456 patients were included: 58.8% (\n n<\/jats:italic>\n = 857) underwent LL and 41.1% (\n n<\/jats:italic>\n = 599) BPD\/DS. Female patients (88.0%,\n n<\/jats:italic>\n = 1,282), mean age of 49.5 \u00b1 9.4 years. Patients undergoing BPD\/DS had higher BMI (47.3 versus 42 kg\/m\n 2<\/jats:sup>\n ), ASA class III\u2013V (91.1% versus 80.7%), drain placement (31.7% versus 9.2%), and robotic approach (40.2% versus 18.7%), longer procedure time (212.2 versus 119.5 minutes), hospital length of stay (2.9 versus 1.5 days), (all\n P<\/jats:italic>\n < .001). BPD\/DS patients had higher OPC (15.2% versus 4.9%), including higher leaks, surgical site infections, and ICU admission, adjusted OR = 3.22 (95% CI = 1.81\u20135.72); they also had higher UHCU (27.2% versus 14.5%). On multivariate analysis, besides BPD\/DS revision, BMI > 50, history of pulmonary embolism, and drain placement were identified as independent risk factors for OPC.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Compared with RYGB-LL, patients undergoing RYGB-BPD\/DS had longer operative time, hospital stay, and OPC. BPD\/DS as a conversion technique, BMI > 50, history of pulmonary embolism, and drain placement were identified as independent risk factor for OPC.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10926429261491051","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:15:02Z","timestamp":1790144102000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Revisional Options after Roux-en-Y Gastric Bypass: A MBSAQIP Analysis of Biliopancreatic Diversion with Duodenal Switch Versus Limb Lengthening"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9077-1460","authenticated-orcid":false,"given":"Yeisson","family":"Rivero-Moreno","sequence":"first","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center\/Albert Einstein College of Medicine, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Estrada","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center\/Albert Einstein College of Medicine, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center\/Albert Einstein College of Medicine, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Moran-Atkin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center\/Albert Einstein College of Medicine, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Camacho","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center\/Albert Einstein College of Medicine, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13607"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-023-06832-8"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-016-2201-5"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-015-1615-9"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-023-06524-3"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-07219-6"},{"key":"e_1_3_3_8_1","unstructured":"7.User Guide for the 2023 Participant Use Data File (PUF). 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