Conversion Surgery for Failed Adjustable Gastric Banding: Outcomes with Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass


Avsar F. M., Sapmaz A., Uluer A., ERDEM N. Z.

Obesity Surgery, vol.28, no.11, pp.3573-3579, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 28 Issue: 11
  • Publication Date: 2018
  • Doi Number: 10.1007/s11695-018-3397-3
  • Journal Name: Obesity Surgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.3573-3579
  • Keywords: Laparoscopic Roux-en-Y gastric bypass, LRYGB, Laparoscopic sleeve gastrectomy, LSG, Laparoscopic adjustable gastric banding, LAGB, Conversion, Redo surgery
  • Istanbul Medipol University Affiliated: Yes

Abstract

Objectives: Laparoscopic adjustable gastric banding (LAGB) was once a preferred method of obesity treatment featuring a straightforward technique, removability, and good early results. In a significant proportion of patients, however, it was not a durable weight-loss procedure and has been associated with a high longer-term complication rate. The purpose of this study was to directly compare the results of conversion to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) after failed LAGB. Methods: Post-LAGB complications and weight outcomes of conversion (absolute weight, excess weight loss [%EWL], total weight loss [%TWL]) to LSG vs LRYGB were retrospectively reviewed and statistically compared using Fisher’s exact test and the independent samples t test. Results: Over a 6-year period, 74/272 (27.2%) morbidly obese LAGB patients experienced marked complications requiring band removal. Forty-nine of these patients underwent conversion by LRYGB (n = 29) or LSG (n = 20). There was no statistically significant difference in complication rates between converted procedures and no significant difference in respective EWL and TWL (6-month EWL: LRYGB, 53.6% vs LSG, 51.3% and respective TWL, 22.8 vs 21.3%; 12-month EWL, 70.1 vs 56.1%; and TWL, 30.7 vs 23.2%; p > 0.05). All conversion patients were present at each time point. Conclusions: Outcomes for LSG vs LRYGB following failed LAGB were equally safe and effective.