Clinical Outcomes of Sleeve Gastrectomy Versus Roux-En-Y Gastric Bypass After Failed Adjustable Gastric Banding

Overview

Journal Obes Surg

Date 2019 Jul 12

PMID 31292884

Citations 11

Authors

Chang Wu

Fu-Gang Wang

Wen-Mao Yan

Ming Yan

Mao-Min Song

Affiliations

Soon will be listed here.

Abstract

Background: Over recent decades, laparoscopic adjustable gastric banding (LAGB) has been among the most common bariatric surgeries. Nowadays, many patients require revision surgery due to insufficient weight loss and band-related complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the two most common revision surgeries for failed LAGB, but the conclusions about their efficacy and safety have been inconsistent. This meta-analysis aimed to review the clinical outcomes of SG and RYGB after failed LAGB.

Methods: In accordance with the PRISMA guidelines, the PubMed, Embase, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were systematically searched for articles that had studied the efficacy and safety of SG and RYGB. The most appropriate effects model was chosen based on the heterogeneity of the articles included in this meta-analysis. Statistical analysis was conducted using Stata 14.0.

Results: Of 586 articles that were retrieved, 16 articles which examined 2141 SG and 2990 RYGB patients met the inclusion criteria. The patients in RYGB groups showed increased percent excess weight loss (%EWL) at 12 and 24 months after revision surgery but no statistically significant change was found about %EWL after 3, 6, or 36 months. In addition, RYGB was associated with a higher rate of complications, interventions, and readmission in addition to being of more operative time.

Conclusions: This review suggested that RYGB was more effective at demonstrating weight loss after 12 and 24 months, but comparisons of the long-term efficacy of RYGB with that of SG remain inconclusive. In addition, RYGB was accompanied by a greater number of post-operative complications, interventions, and readmissions. Thus, surgeons should consider the overall status of the patients and their comorbidities as crucial factors when selecting a form of revision surgery. Additional high-quality randomized controlled studies are required to further compare the efficacy and safety of these treatments with longer follow-up times.

Citing Articles

Revisional One-Step Bariatric Surgical Techniques After Unsuccessful Laparoscopic Gastric Band: A Retrospective Cohort Study with 2-Year Follow-up.

Hany M, Zidan A, Ibrahim M, Sabry A, Agayby A, Mourad M Obes Surg. 2024; 34(3):814-829.

PMID: 38231451 PMC: 10899297. DOI: 10.1007/s11695-023-07039-7.

Long-term Outcomes of Laparoscopic Sleeve Gastrectomy as a Revisional Procedure Following Adjustable Gastric Banding: Variations in Outcomes Based on Indication.

Wickremasinghe A, Leang Y, Johari Y, Chana P, Alderuccio M, Shaw K Obes Surg. 2023; 33(12):3722-3739.

PMID: 37847457 PMC: 10687173. DOI: 10.1007/s11695-023-06886-8.

Roux-en-Y Gastric Bypass as Conversion Procedure of Failed Gastric Banding: Short-Term Outcomes of 1295 Patients in One Single Center.

Handojo K, Ismaeil A, Van Huele A, Van Neste C, Debergh I, Dillemans B Obes Surg. 2023; 33(10):2963-2972.

PMID: 37548925 PMC: 10514178. DOI: 10.1007/s11695-023-06746-5.

Revisional bariatric surgery after adjustable gastric band: a multicenter Polish Revision Obesity Surgery Study (PROSS).

Dowgiallo-Gornowicz N, Janik M, Lech P, Kowalski G, Major P BMC Surg. 2023; 23(1):94.

PMID: 37081459 PMC: 10120208. DOI: 10.1186/s12893-023-02002-w.

Revisional Surgery After Adjustable Gastric Banding: Sleeve Gastrectomy or Gastric Bypass?.

Park Y J Metab Bariatr Surg. 2023; 11(2):49-53.

PMID: 36926677 PMC: 10011676. DOI: 10.17476/jmbs.2022.11.2.49.

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