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Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass.
Br J Surg. 2014 Feb; 101(3):254-60.BJ

Abstract

BACKGROUND

Laparoscopic adjustable gastric banding (LAGB) has a high incidence of long-term complications and failures. The best procedure to handle these failures and the optimal number of stages in such cases is still controversial. The aim of this retrospective study was to compare the results of conversions of LAGB to either laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) in failed LAGB using a single-stage approach.

METHODS

All patients who underwent conversion from LAGB to either LRYGB or LSG between January 2005 and March 2012 were included in the study. Early and late complications were reviewed. The percentage excess weight loss (%EWL) between the two groups was compared at 3, 6, 12 and 24 months of follow-up.

RESULTS

Fifty-nine patients, 11 men and 48 women, were included in the study. The most frequent indication was insufficient weight loss or weight regain (non-responders group), in 44 patients (75 per cent); 15 patients had a revision for complicated LAGB. The early complication rate in the non-responders group was 7 per cent (3 of 44 patients), compared with 13 per cent (2 of 15) in the complicated LAGB group. Mean(s.d.) %EWL in the non-responders group was 55(22) per cent in patients converted to LRYGB and 28(25) in those converted to LSG (P = 0·001).

CONCLUSION

LRYGB and LSG are both safe and feasible options for failed or complicated LAGB. In the non-responders group, %EWL was superior for conversion to LRYGB. The surgical morbidity rate was highest in patients having revision for band complications.

Authors+Show Affiliations

The Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Department of General Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, Florida, 33331, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

24469622

Citation

Marin-Perez, P, et al. "Outcomes After Laparoscopic Conversion of Failed Adjustable Gastric Banding to Sleeve Gastrectomy or Roux-en-Y Gastric Bypass." The British Journal of Surgery, vol. 101, no. 3, 2014, pp. 254-60.
Marin-Perez P, Betancourt A, Lamota M, et al. Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass. Br J Surg. 2014;101(3):254-60.
Marin-Perez, P., Betancourt, A., Lamota, M., Lo Menzo, E., Szomstein, S., & Rosenthal, R. (2014). Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass. The British Journal of Surgery, 101(3), 254-60. https://doi.org/10.1002/bjs.9344
Marin-Perez P, et al. Outcomes After Laparoscopic Conversion of Failed Adjustable Gastric Banding to Sleeve Gastrectomy or Roux-en-Y Gastric Bypass. Br J Surg. 2014;101(3):254-60. PubMed PMID: 24469622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass. AU - Marin-Perez,P, AU - Betancourt,A, AU - Lamota,M, AU - Lo Menzo,E, AU - Szomstein,S, AU - Rosenthal,R, PY - 2013/09/18/accepted PY - 2014/1/29/entrez PY - 2014/1/29/pubmed PY - 2014/3/19/medline SP - 254 EP - 60 JF - The British journal of surgery JO - Br J Surg VL - 101 IS - 3 N2 - BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) has a high incidence of long-term complications and failures. The best procedure to handle these failures and the optimal number of stages in such cases is still controversial. The aim of this retrospective study was to compare the results of conversions of LAGB to either laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) in failed LAGB using a single-stage approach. METHODS: All patients who underwent conversion from LAGB to either LRYGB or LSG between January 2005 and March 2012 were included in the study. Early and late complications were reviewed. The percentage excess weight loss (%EWL) between the two groups was compared at 3, 6, 12 and 24 months of follow-up. RESULTS: Fifty-nine patients, 11 men and 48 women, were included in the study. The most frequent indication was insufficient weight loss or weight regain (non-responders group), in 44 patients (75 per cent); 15 patients had a revision for complicated LAGB. The early complication rate in the non-responders group was 7 per cent (3 of 44 patients), compared with 13 per cent (2 of 15) in the complicated LAGB group. Mean(s.d.) %EWL in the non-responders group was 55(22) per cent in patients converted to LRYGB and 28(25) in those converted to LSG (P = 0·001). CONCLUSION: LRYGB and LSG are both safe and feasible options for failed or complicated LAGB. In the non-responders group, %EWL was superior for conversion to LRYGB. The surgical morbidity rate was highest in patients having revision for band complications. SN - 1365-2168 UR - https://www.unboundmedicine.com/medline/citation/24469622/Outcomes_after_laparoscopic_conversion_of_failed_adjustable_gastric_banding_to_sleeve_gastrectomy_or_Roux_en_Y_gastric_bypass_ L2 - https://doi.org/10.1002/bjs.9344 DB - PRIME DP - Unbound Medicine ER -