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Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve.
Surg Obes Relat Dis. 2014 Nov-Dec; 10(6):1085-91.SO

Abstract

BACKGROUND

Despite its worldwide popularity, laparoscopic adjustable gastric banding (LAGB) requires revisional surgery for failures or complications, in 20-60% of cases. The purpose of this study was to compare in terms of efficacy and safety, the conversion of failed LAGB to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy. (LSG).

METHODS

The bariatric database of our institution was reviewed to identify patients who had undergone conversion of failed LAGB to LRYGB or to LSG, from November 2007 to June 2012.

RESULTS

A total of 108 patients were included. Of these, 74 (68.5%) underwent conversion to LRYGB and 34 to LSG. All of the procedures were performed in 2-stage and laparoscopically. The mean follow-up for the LRYGB group was 29.1±17.9 months while for the LSG patients was 24.2±14.3 months. The mean body mass index (BMI) prior LRYGB and LSG was 45.6±7.8 and 47.5±5.6 (P = .09), respectively. Postoperative complications occurred in 16.2% of the LRYGB patients and in 2.9% of the LSG group (P = .04). Mean percentage of excess weight loss was 59.9%±16.2% and 70.2%±16.7% in LRYGB, and it was 52.2%±11.4% and 59.9%±14.4% in LSG at 12 months (P = .007) and 24 months (P = .01) after conversion.

CONCLUSION

In this series, LRYGB and LSG are both effective and adequate revisional procedure after failure of LAGB. While LRYGB seems to ensure greater weight loss at 24 months follow-up, LSG is associated with a lower postoperative morbidity.

Authors+Show Affiliations

Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France. Electronic address: sergio.carandina@jvr.aphp.fr.Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France.Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France.Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France.Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France.Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France.Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25066441

Citation

Carandina, Sergio, et al. "Two-step Conversion Surgery After Failed Laparoscopic Adjustable Gastric Banding. Comparison Between Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Gastric Sleeve." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 10, no. 6, 2014, pp. 1085-91.
Carandina S, Maldonado PS, Tabbara M, et al. Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve. Surg Obes Relat Dis. 2014;10(6):1085-91.
Carandina, S., Maldonado, P. S., Tabbara, M., Valenti, A., Rivkine, E., Polliand, C., & Barrat, C. (2014). Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 10(6), 1085-91. https://doi.org/10.1016/j.soard.2014.03.017
Carandina S, et al. Two-step Conversion Surgery After Failed Laparoscopic Adjustable Gastric Banding. Comparison Between Laparoscopic Roux-en-Y Gastric Bypass and Laparoscopic Gastric Sleeve. Surg Obes Relat Dis. 2014 Nov-Dec;10(6):1085-91. PubMed PMID: 25066441.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve. AU - Carandina,Sergio, AU - Maldonado,Pablo S, AU - Tabbara,Malek, AU - Valenti,Antonio, AU - Rivkine,Emmanuel, AU - Polliand,Claude, AU - Barrat,Christophe, Y1 - 2014/03/28/ PY - 2013/10/23/received PY - 2014/03/25/revised PY - 2014/03/25/accepted PY - 2014/7/29/entrez PY - 2014/7/30/pubmed PY - 2015/9/10/medline KW - Conversion KW - Gastric banding KW - Gastric bypass KW - Postoperative complication KW - Revision KW - Sleeve gastrectomy SP - 1085 EP - 91 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 10 IS - 6 N2 - BACKGROUND: Despite its worldwide popularity, laparoscopic adjustable gastric banding (LAGB) requires revisional surgery for failures or complications, in 20-60% of cases. The purpose of this study was to compare in terms of efficacy and safety, the conversion of failed LAGB to laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy. (LSG). METHODS: The bariatric database of our institution was reviewed to identify patients who had undergone conversion of failed LAGB to LRYGB or to LSG, from November 2007 to June 2012. RESULTS: A total of 108 patients were included. Of these, 74 (68.5%) underwent conversion to LRYGB and 34 to LSG. All of the procedures were performed in 2-stage and laparoscopically. The mean follow-up for the LRYGB group was 29.1±17.9 months while for the LSG patients was 24.2±14.3 months. The mean body mass index (BMI) prior LRYGB and LSG was 45.6±7.8 and 47.5±5.6 (P = .09), respectively. Postoperative complications occurred in 16.2% of the LRYGB patients and in 2.9% of the LSG group (P = .04). Mean percentage of excess weight loss was 59.9%±16.2% and 70.2%±16.7% in LRYGB, and it was 52.2%±11.4% and 59.9%±14.4% in LSG at 12 months (P = .007) and 24 months (P = .01) after conversion. CONCLUSION: In this series, LRYGB and LSG are both effective and adequate revisional procedure after failure of LAGB. While LRYGB seems to ensure greater weight loss at 24 months follow-up, LSG is associated with a lower postoperative morbidity. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/25066441/Two_step_conversion_surgery_after_failed_laparoscopic_adjustable_gastric_banding__Comparison_between_laparoscopic_Roux_en_Y_gastric_bypass_and_laparoscopic_gastric_sleeve_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(14)00139-7 DB - PRIME DP - Unbound Medicine ER -