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Surg Obes Relat Dis. 2014 Nov-Dec;10(6):1085-91. doi: 10.1016/j.soard.2014.03.017. Epub 2014 Mar 28.

Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve.

Author information

1
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.
2
Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Paris, France.

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.

KEYWORDS:

Conversion; Gastric banding; Gastric bypass; Postoperative complication; Revision; Sleeve gastrectomy

PMID:
25066441
DOI:
10.1016/j.soard.2014.03.017
[Indexed for MEDLINE]

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