Abstract
Background
No verdict has been reached on single-stage removal of gastric banding with sleeve
gastrectomy.
Objectives
To report 5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy (Conversion-LSG)
compared with primary laparoscopic sleeve gastrectomy (Prim-LSG).
Setting
Large single-surgeon prospective database.
Methods
Two patient groups were included: Conversion-LSG as the study group and Prim-LSG for
comparison. Preconversion characteristics, conversion indication, weight loss, and
complications were compared. The surgical protocol was reviewed, focusing on key technical
recommendations.
Results
A total of 209 Conversion-LSG and 3268 Prim-LSG patients, aged 32.9±9.8 and 31.8±10.7
years respectively (P = .2), were studied. No significant differences in age, body mass index (BMI), or
gender distribution existed. Conversion-LSG Baseline BMI was 47±12 kg/m2. Patients spent 6.2±2.6 years with the band before Conversion-LSG. BMI at 1, 2, 3,
4, and 5 years was 37±8, 31±9, 29±11, 30±9, and 30±11 kg/m2, respectively. No significant difference in BMI change between the 2 groups existed.
In the Conversion-LSG group, 1 patient had a successfully stented leak but developed
a gastrobronchial fistula 1 year later. In the Prim-LSG group, 3 leak cases were reported
and managed successfully through endoscopic stenting, 1 patient had pulmonary embolism
that responded to standard treatment, and 3 patients had postoperative bleeding. No
other major complications occurred, and there was no mortality in either group. Additionally,
no Conversion-LSG patients required further bariatric intervention.
Conclusion
Employing the surgical technique described in this paper, conversion-LSG is as well
tolerated and effective as primary sleeve gastrectomy.
Keywords
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Article info
Publication history
Published online: May 20, 2016
Accepted:
May 15,
2016
Received:
January 27,
2016
Identification
Copyright
© 2016 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
