Two stages conversion of failed laparoscopic adjustable gastric banding to laparoscopic roux-en-y gastric bypass. A study of one hundred patients

J Gastrointest Surg. 2014 Oct;18(10):1730-6. doi: 10.1007/s11605-014-2621-2. Epub 2014 Aug 5.

Abstract

Introduction: Conversion to laparoscopic gastric bypass (LRYGB) appears to be the treatment of choice after failed LAGB. To reduce the risk of postoperative complications, some surgeons routinely adopt a two-stage strategy. The purpose of this study was to analyze our institution's experience with the two-stage procedure for LAGB conversion to LRYGB MATERIALS AND METHODS: The bariatric database of our institution was reviewed to identify patients who had undergone conversion of LAGB to LRYGB from November 2007 to June 2012.

Results: One hundred patients were included. Of these, 62 (62%) required conversion to LRYGB for inadequate weight loss or weight regain and 38 for band-related complications. All the procedures were performed in two stages and laparoscopically. The average time between band removal and LRYGB was 17.3 months. The mean follow-up after LRYGB was 31 ± 18.7 months. The mean BMI prior to LRYGB conversion was 45.3 ± 5.2. Early complications occurred in 15 patients (15%), while late complications occurred in only 3 patients (3%). The average %EWL at 24 months and 48 months after conversion was 70.1 and 69.4%, respectively.

Conclusion: Although a two-stage conversion strategy increases the number of operations and hospital stay without decreasing the rate of early complications compared to one-stage conversion; it has shown to be associated with low rates of GJA stenosis and excellent %EWL.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Gastric Bypass / adverse effects*
  • Gastric Bypass / methods
  • Gastroplasty / adverse effects*
  • Gastroplasty / methods
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / surgery*
  • Reoperation / methods
  • Retrospective Studies
  • Risk Assessment
  • Treatment Failure
  • Treatment Outcome
  • Weight Loss / physiology*
  • Young Adult