Revision Procedures After Failed Adjustable Gastric Banding: Comparison of Efficacy and Safety
Journal
Obesity Surgery
Journal Volume
27
Journal Issue
11
Pages
2861-2867
Date Issued
2017
Author(s)
Abstract
Background: Laparoscopic adjustable gastric banding (LAGB) was one of the commonly performed bariatric operations; however, it carries a high revision rate. The aim of the present study was to report the long-term outcomes of LAGB and compare the outcomes between the different revision procedures. Methods: All patients who underwent LAGB in a large bariatric center in Asia between May 2002 and April 2011 were included. Interval between primary LAGB to the revision operation, the reason and type of revision surgery were identified and analyzed. Results: A total of 275 consecutive patients were included. All of the procedures were completed laparoscopically with no major complications. The percentage of excess weight loss (%EWL) at 10-year follow-up was 45%. In this study, 53 patients (19.3%) had revision surgery, including with 26 single anastomosis (mini-) gastric bypass (R-LSAGB) (49%), 17 sleeve gastrectomy (R-LSG) (32.1%), 9 Roux-en-Y gastric bypass (R-LRYGB) (17%), and 1 other procedure (1.9%). A major complication occurred in 6 patients (11.3%). All of the follow-up patients with revision surgeries had %EWL?>?50% at the 2-year follow-up. R-LSAGB patients achieved better weight loss than those who underwent R-LSG and R-LRYGB (p?=?0.001). Conclusions: The long-term result for weight loss after LAGB is unsatisfactory. The revision of failed LAGB to other bariatric surgeries is safe and can be performed in one stage with a low complication rate. Patients who underwent R-LSAGB had better weight loss results than the R-LSG or R-LRYGB patients. ? 2017, Springer Science+Business Media New York.
Subjects
adolescent; adult; anastomosis; Article; clinical effectiveness; cohort analysis; controlled study; erosion; female; follow up; gastric banding; hospitalization; human; major clinical study; male; operation duration; outcome assessment; pain; postoperative vomiting; priority journal; reoperation; retrospective study; Roux-en-Y gastric bypass; safety; sleeve gastrectomy; weight reduction; bariatric surgery; body weight loss; comparative study; evaluation study; gastrectomy; gastric bypass surgery; gastroplasty; laparoscopy; morbid obesity; procedures; reoperation; treatment outcome; Adult; Bariatric Surgery; Female; Follow-Up Studies; Gastrectomy; Gastric Bypass; Gastroplasty; Humans; Laparoscopy; Male; Obesity, Morbid; Reoperation; Retrospective Studies; Treatment Outcome; Weight Loss
SDGs
Type
journal article