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Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass?
Surg Obes Relat Dis. 2013 Nov-Dec; 9(6):901-7.SO

Abstract

BACKGROUND

In the literature, late complications and treatment failures in laparoscopic adjustable gastric banding (LAGB) have been reported. When the patient presents with failure of LAGB, surgeons have the option to convert it to a different procedure. The aim of our study is to evaluate and compare the safety and efficacy of converting LAGB to laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB).

METHODS

Between March 2008 and October 2012, a total of 54 patients underwent conversion of LAGB at our institution. Of these patients, 41 (75.9%) were converted to LRYGB, and 13 (24.1%) patients were converted to LSG. A retrospective review of a prospectively collected database was performed, noting the outcomes and complications of the procedure.

RESULTS

Mean body mass index at the time of conversion was 41.8±6.5 kg/m(2) in LRYGB and 39.0±6.6 kg/m(2) in LSG. Mean percentage of excess weight loss was 57.4%±17.0% and 62.4%±19.6% in LRYGB, and it was 47.7%±4.2% and 65.6%±34.5% in LSG at 12 months (P>.34) and 24 months (P>.79) after conversion. Of LRYGB patients, 7 (17.5%) were readmitted as a result of abdominal pain, dehydration, and nausea/vomiting, and 4 (10.0%) patients required reoperation. One LSG patient (8.3%) was readmitted for new-onset severe reflux and underwent hiatal hernia repair. She was converted to LRYGB 32 months after the LSG procedure. Readmission rate (P>.61) and reoperation rate (P>.63) did not show statistical difference between the 2 procedures.

CONCLUSION

Converting LAGB to LSG and LRYGB both seem feasible and resulted in substantial further weight loss.

Authors+Show Affiliations

Department of Bariatric Surgery, Orlando Regional Medical Center & Bariatric and Laparoscopy Center, Orlando Health, Orlando, Florida.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23769112

Citation

Moon, Rena C., et al. "Conversion of Failed Laparoscopic Adjustable Gastric Banding: Sleeve Gastrectomy or Roux-en-Y Gastric Bypass?" Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 9, no. 6, 2013, pp. 901-7.
Moon RC, Teixeira AF, Jawad MA. Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass? Surg Obes Relat Dis. 2013;9(6):901-7.
Moon, R. C., Teixeira, A. F., & Jawad, M. A. (2013). Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass? Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 9(6), 901-7. https://doi.org/10.1016/j.soard.2013.04.003
Moon RC, Teixeira AF, Jawad MA. Conversion of Failed Laparoscopic Adjustable Gastric Banding: Sleeve Gastrectomy or Roux-en-Y Gastric Bypass. Surg Obes Relat Dis. 2013 Nov-Dec;9(6):901-7. PubMed PMID: 23769112.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass? AU - Moon,Rena C, AU - Teixeira,Andre F, AU - Jawad,Muhammad A, Y1 - 2013/04/17/ PY - 2013/02/15/received PY - 2013/04/09/revised PY - 2013/04/09/accepted PY - 2013/6/18/entrez PY - 2013/6/19/pubmed PY - 2014/9/5/medline KW - Complications KW - Conversion KW - Gastric banding KW - Gastric bypass KW - Revision KW - Sleeve gastrectomy KW - Weight regain SP - 901 EP - 7 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 9 IS - 6 N2 - BACKGROUND: In the literature, late complications and treatment failures in laparoscopic adjustable gastric banding (LAGB) have been reported. When the patient presents with failure of LAGB, surgeons have the option to convert it to a different procedure. The aim of our study is to evaluate and compare the safety and efficacy of converting LAGB to laparoscopic sleeve gastrectomy (LSG) versus laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Between March 2008 and October 2012, a total of 54 patients underwent conversion of LAGB at our institution. Of these patients, 41 (75.9%) were converted to LRYGB, and 13 (24.1%) patients were converted to LSG. A retrospective review of a prospectively collected database was performed, noting the outcomes and complications of the procedure. RESULTS: Mean body mass index at the time of conversion was 41.8±6.5 kg/m(2) in LRYGB and 39.0±6.6 kg/m(2) in LSG. Mean percentage of excess weight loss was 57.4%±17.0% and 62.4%±19.6% in LRYGB, and it was 47.7%±4.2% and 65.6%±34.5% in LSG at 12 months (P>.34) and 24 months (P>.79) after conversion. Of LRYGB patients, 7 (17.5%) were readmitted as a result of abdominal pain, dehydration, and nausea/vomiting, and 4 (10.0%) patients required reoperation. One LSG patient (8.3%) was readmitted for new-onset severe reflux and underwent hiatal hernia repair. She was converted to LRYGB 32 months after the LSG procedure. Readmission rate (P>.61) and reoperation rate (P>.63) did not show statistical difference between the 2 procedures. CONCLUSION: Converting LAGB to LSG and LRYGB both seem feasible and resulted in substantial further weight loss. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/23769112/Conversion_of_failed_laparoscopic_adjustable_gastric_banding:_sleeve_gastrectomy_or_Roux_en_Y_gastric_bypass L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(13)00108-1 DB - PRIME DP - Unbound Medicine ER -