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J Minim Access Surg. 2019 Apr 24. doi: 10.4103/jmas.JMAS_86_18. [Epub ahead of print]

Decreasing complication rates for one-stage conversion band to laparoscopic sleeve gastrectomy: A retrospective cohort study.

Author information

1
Department of Surgery, Division of Bariatric Surgery, Sacré-Coeur Hospital of Montreal, University of Montreal, 5400 boul. Gouin Ouest Montréal, Québec H4J 1C5, Canada.
2
Montreal Behavioural Medicine Centre, Sacré-Coeur Hospital of Montreal, University of Montreal, 5400 boul. Gouin Ouest Montréal, Québec H4J 1C5, Canada.

Abstract

Background:

Laparoscopic adjustable gastric banding (LAGB) revision surgery is often necessary because of its high failure rate. The objective of this study was to demonstrate that better patient selection, when converting a failed LAGB to a laparoscopic sleeve gastrectomy (LSG) as a one-stage revision procedure, is safe, feasible and improves the complication rate.

Patients and Methods:

A retrospective chart review was performed on patients who underwent a one-stage conversion of failed gastric banding to a LSG. Collected data included age, sex, body mass index (BMI), intraoperative complications, length of stay and post-operative complications. The results were compared to a previous study of 90 cases of LSG as a revision procedure for failed LAGB.

Results:

There were 75 patients in the current study, 61 women and 14 men, aged 25-67 (average: 46), with a mean BMI of 45 kg/m2 (32-66). Seventy patients (93.3%) were operated for insufficient weight loss and 5 patients (6.7%) for intolerance to the band. In our previous study, 35 patients (39%) were operated for slippage, erosion or obstruction and 14 (15.6%) had post-operative complications as opposed to only 4 patients (5.3%) in this series (P = 0.0359). Gastric leak also improved to 1.3% compared to 5.5% previously. Average hospitalisation time was 2.5 days (1-40).

Conclusions:

Rigorous patient selection, without band complications such as slippage, erosion or obstruction, allows for a significantly lower rate of operative complications for a one-stage conversion of failed gastric banding to a LSG.

KEYWORDS:

Laparoscopic adjustable gastric banding; laparoscopic sleeve gastrectomy; morbid obesity; revisional surgery

PMID:
31031324
DOI:
10.4103/jmas.JMAS_86_18
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