Laparoscopic Removal of Poor Outcome Gastric Banding with Concomitant Sleeve Gastrectomy

Overview

Journal Obes Surg

Date 2013 Mar 7

PMID 23462858

Citations 10

Authors

Aayed R Alqahtani

Mohamed Elahmedi

Hussam Alamri

Rafiuddin Mohammed

Fatima Darwish

Ali M Ahmed

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopic adjustable gastric banding (LAGB) has a significant incidence of long-term failure, which may require an alternative revisional bariatric procedure to remediate. Unfortunately, there is few data pinpointing which specific revisional procedure most effectively addresses failed gastric banding. Recently, it has been observed that laparoscopic sleeve gastrectomy (LSG) is a promising primary bariatric procedure; however, its use as a revisional procedure has been limited. This study aims to evaluate the safety and efficacy of LSG performed concomitantly with removal of a poor-outcome LAGB.

Methods: A retrospective review was performed on patients who underwent LAGB removal with concomitant LSG at King Saud University in Saudi Arabia between September 2007 and April 2012. Patient body mass index (BMI), percentage of excess weight loss (%EWL), duration of operation, length of hospital stay, complications after LSG, and indications for revisional surgery were all reviewed and compared to those of patients who underwent LSG as a primary procedure.

Results: Fifty-six patients (70 % female) underwent conversion of LAGB to LSG concomitantly, and 128 (66 % female) patients underwent primary LSG surgery. The revisional and primary LSG patients had similar preoperative ages (mean age 33.5 ± 10.7 vs. 33.6 ± 9.0 years, respectively; p = 0.43). However, revisional patients had a significantly lower BMI at the time of surgery (44.4 ± 7.0 kg/m(2) vs. 47.9 ± 8.2; p < 0.01). Absolute BMI postoperative reduction at 24 months was 14.33 points in the revision group and 18.98 points in the primary LSG group; similar %EWL was achieved by both groups at 24 months postoperatively (80.1 vs. 84.6 %). Complications appeared in two (5.5 %) revisional patients and in nine (7.0 %) primary LSG patients. No mortalities occurred in either group.

Conclusions: Conversion of LAGB by means of concomitant LSG is a safe and efficient procedure and achieves similar outcomes as primary LSG surgery alone.

Citing Articles

Roux-en-Y gastric bypass and sleeve gastrectomy as revisional bariatric procedures after adjustable gastric banding: a retrospective cohort study.

Santos-Sousa H, Nogueiro J, Lindeza L, Carmona M, Amorim-Cruz F, Resende F Langenbecks Arch Surg. 2023; 408(1):441.

PMID: 37987830 PMC: 10663205. DOI: 10.1007/s00423-023-03174-y.

Outcomes of primary sleeve gastrectomy versus conversion sleeve gastrectomy in morbidly obese patients.

Park J, Han S Ann Surg Treat Res. 2019; 96(5):259-265.

PMID: 31073516 PMC: 6483934. DOI: 10.4174/astr.2019.96.5.259.

The Impact of Technical Surgical Aspects on Morbidity of 984 Patients after Sleeve Gastrectomy for Morbid Obesity.

Guetta O, Ovnat A, Czeiger D, Vakhrushev A, Tsaban G, Sebbag G Obes Surg. 2017; 27(11):2785-2791.

PMID: 28540622 DOI: 10.1007/s11695-017-2721-7.

Systematic Review and Meta-Analysis of Outcomes After Revisional Bariatric Surgery Following a Failed Adjustable Gastric Band.

Sharples A, Charalampakis V, Daskalakis M, Tahrani A, Singhal R Obes Surg. 2017; 27(10):2522-2536.

PMID: 28477245 DOI: 10.1007/s11695-017-2677-7.

Laparoscopic Conversion of Gastric Bypass Complication to Sleeve Gastrectomy: Technique and Early Results.

Chen C, Lee W, Lee H, Chen J, Ser K, Lee Y Obes Surg. 2016; 26(9):2014-2021.

PMID: 26781694 DOI: 10.1007/s11695-016-2066-7.

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