Adjustable Gastric Banding Conversion to One Anastomosis Gastric Bypass: Data Analysis of a Multicenter Database

J Gastrointest Surg. 2022 Jun;26(6):1147-1153. doi: 10.1007/s11605-022-05277-1. Epub 2022 Mar 1.

Abstract

Introduction: One anastomosis gastric bypass (OAGB) has been proposed as a rescue technique for laparoscopic adjustable gastric banding (LAGB) poor responders.

Aim: We sought to analyze, complications, mortality, and medium-term weight loss results after LAGB conversion to OAGB.

Methods: Data analysis of an international multicenter database.

Results: One hundred eighty-nine LAGB-to-OAGB operations were retrospectively analyzed. Eighty-seven (46.0%) were converted in one stage. Patients operated on in two stages had a higher preoperative body mass index (BMI) (37.9 vs. 41.3 kg/m2, p = 0.0007) and were more likely to have encountered technical complications, such as slippage or erosions (36% vs. 78%, p < 0.0001). Postoperative complications occurred in 4.8% of the patients (4.6% and 4.9% in the one-stage and the two-stage group, respectively). Leak rate, bleeding episodes, and mortality were 2.6%, 0.5%, and 0.5%, respectively. The final BMI was 30.2 at a mean follow-up of 31.4 months. Follow-up at 1, 3, and 5 years was 100%, 88%, and 70%, respectively.

Conclusion: Conversion from LAGB to OAGB is safe and effective. The one-stage approach appears to be the preferred option in non-complicate cases, while the two-step approach is mostly done for more complicated cases.

Keywords: Conversion; Gastric banding; LAGB; OAGB; One anastomosis gastric bypass; Revision; Revisional surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Data Analysis
  • Gastric Bypass* / adverse effects
  • Gastric Bypass* / methods
  • Gastroplasty* / adverse effects
  • Gastroplasty* / methods
  • Humans
  • Laparoscopy* / methods
  • Obesity, Morbid* / complications
  • Obesity, Morbid* / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Reoperation / adverse effects
  • Retrospective Studies
  • Treatment Outcome