Efficiency of Laparoscopic One-Step Revision of Failed Adjusted Gastric Banding to Gastric Sleeve: a Retrospective Review of 101 Consecutive Patients

• Published in: Obesity surgery Vol. 29; no. 12; pp. 3868 - 3873
• Main Authors: Thomopoulos, Theodoros, Podetta, Michele, Studer, Anne-Sophie, Atlas, Henri, Pescarus, Radu, Denis, Ronald, Garneau, Pierre Y.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2019; Springer Nature B.V
• Subjects: Adult; Aged; Female; Follow-Up Studies; Gastrectomy - methods; Gastrointestinal surgery; Gastroplasty - methods; Humans; Laparoscopy; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - surgery; Original Contributions; Reoperation - methods; Retrospective Studies; Surgery; Treatment Outcome; Weight Loss; Gastric sleeve; Revisional surgery; Gastric band; Weight loss
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-019-04061-6

Background Until recently, laparoscopic adjustable gastric banding (LAGB) was one of the most commonly performed bariatric surgeries worldwide. Today, its high rate of complications and failure rates up to 70% requires revisional surgery. The one-stage conversion from LAGB to laparoscopic sleeve gastrectomy (LSG) has been shown to be safe, although there are some concerns on efficacy and long-term weight loss. Objectives To demonstrate that one-step revision of LAGB to another restrictive procedure, such as LSG, might have efficient long-term outcomes. Methods The charts from 133 revisional LSGs for failed or complicated LAGB were retrospectively reviewed for the period between January 2010 and August 2017. Thirty-two patients were excluded for loss to follow-up. Demographics, complications, and percentage of excess weight loss (%EWL) were determined. Results One hundred one patients were included (85 women and 16 men), with a mean age of 48.5 years, and a mean body mass index of 47.1 kg/m 2 . During the follow-up, 15 patients (15%) underwent a second revisional surgery for weight loss failure (8 Roux-en-Y gastric bypass (RYGBP), 3 biliopancreatic diversion, 3 single anastomosis duodenal-ileal bypass, 1 revisional LSG). Ten patients (10%) had long-term complications (8 severe reflux and 2 stenosis) during this period and underwent a second revisional surgery (10 RYGBP). The remaining 76 had a mean follow-up of 4.3 years and a mean %EWL of 53.2%. Conclusion Single-stage conversion to LSG is a safe and appropriate solution for failed or complicated LAGB with good long-term weight loss.