Safety of one-stage conversion surgery after failed gastric band: our experience and review of the literature

Updates Surg. 2019 Sep;71(3):445-450. doi: 10.1007/s13304-018-0598-1. Epub 2018 Nov 22.

Abstract

The laparoscopic adjustable gastric band (AGB) has fallen out of favor due to poor long-term weight loss and frequent complications. Many patients stand to benefit from elective conversion of AGB to more durable procedures such as sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Whether it is safer to perform this conversion in one or two stages, however, remains controversial. We performed an IRB-approved review of prospectively collected data from all one-stage band conversions performed at our institution from January 2012 to December 2017. Patients were separated into two groups: those who underwent conversion to either a RYGB or SG. Demographics, indications, and outcomes of each group were compared using Fisher's exact test, Mann-Whitney rank sums, and chi-squared tests. Outcomes were recorded within a 1-year follow-up period and compared to published outcomes for one-stage band conversions. Thirty-eight patients were included for analysis. Average age and BMI were was 50.8 years and 41.1 kg/m2, respectively. The average operative time (164 min, 105-258 min) and length of stay (2.2 days, 1-5 days) did not differ between indication and procedure performed. Overall, early (< 30 day) and late (> 30 day) major complication rates were 7.9% and 5.3%, respectively. There were no leaks and no deaths. Within a 1-year postoperative period, seven re-interventions were performed. Elective one-stage band conversion to RYGB or SG can be performed safely.

Keywords: Conversion; Gastric band; Gastric bypass; One stage; Safety; Sleeve gastrectomy.

Publication types

  • Review

MeSH terms

  • Female
  • Gastrectomy / methods
  • Gastric Bypass / methods
  • Gastroplasty / adverse effects*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Operative Time
  • Reoperation / adverse effects*
  • Reoperation / methods
  • Retrospective Studies
  • Treatment Failure