Highlights
- •The largest analysis to date of outcomes following single-stage conversions of gastric bands to either sleeve gastrectomy or gastric bypass.
- •Data have been obtained from the United Kingdom National Bariatric Surgery Registry, a prospectively-collated bespoke database.
- •Conversions from band to sleeve or bypass give comparable good early excess weight loss.
- •However conversion to sleeve is associated with a better peri-operative safety profile.
Abstract
Background
For patients in whom laparoscopic adjustable gastric band has failed, conversion to
Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy are both options for
further surgical treatment. There are limited data comparing these 2 procedures. The
National Bariatric Surgery Registry is a comprehensive United Kingdom–wide database
of bariatric procedures, in which preoperative demographic characteristics and clinical
outcomes are prospectively recorded.
Objectives
To compare perioperative complication rate and short-term outcomes of patients undergoing
single-stage conversion of gastric band to Roux-en-Y gastric bypass or laparoscopic
sleeve gastrectomy.
Setting
United Kingdom national bariatric surgery database.
Methods
From the National Bariatric Surgical Registry data set, we identified 141 patients
undergoing single-stage conversion from gastric band to either gastric bypass (113)
or sleeve gastrectomy (28) between 2009 and 2014, and analyzed their clinical outcomes.
Results
With respect to perioperative outcomes gastric bypass was associated with a higher
incidence of readmission or reintervention postoperatively (16 versus 0; P = .04). There was no difference in percentage excess weight loss between sleeve gastrectomy
and gastric bypass at final follow-up at 1 year (52.1% versus 57.1% respectively;
P = .4).
Conclusions
Conversion from band to sleeve or bypass give comparable good early excess weight
loss; however, conversion to sleeve is associated with a better perioperative safety
profile.
Key words
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References
- Long-term results after laparoscopic adjustable gastric banding for morbid obesity: 18-year follow-up in a single university unit.Obes Surg. 2017; 27: 630-640
- Surgery for weight loss in adults.Cochrane Database Syst Rev. 2014; CD003641
Estimate of Bariatric Surgery Numbers, 2011-2017 [homepage on the Internet]. Gainesville: American Society for Metabolic and Bariatric Surgery; c2018 [updated 2018 Jun; cited 2018 Jan 15]. Available from: https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers.
- Concomitant removal of gastric band and gastric bypass: analysis of outcomes and complications from the ACS-NSQIP database.Obes Surg. 2017; 27: 462-468
- Concomitant removal of gastric band and sleeve gastrectomy: analysis of outcomes and complications from the ACS-NSQIP database.Surg Obes Relat Dis. 2016; 12: 984-988
- Sleeve gastrectomy for gastric band failures - a prospective study.Int J Surg. 2013; 11: 407-409
- A one-step conversion from gastric banding to laparoscopic Roux-en-Y gastric bypass is as safe as a two-step conversion: a comparative analysis of 885 patients.Acta Chir Belg. 2016; 116: 271-277
- Revisions after failed gastric band: sleeve gastrectomy and Roux-en-Y gastric bypass.Surg Endosc. 2015; 29: 2533-2537
- Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass?.Surg Obes Relat Dis. 2013; 9: 901-907
- A retrospective comparison of early results of conversion of failed gastric banding to sleeve gastrectomy or gastric bypass.Surg Obes Relat Dis. 2015; 11: 379-384
- Systematic review and meta-analysis of outcomes after revisional bariatric surgery following a failed adjustable gastric band.Obes Surg. 2017; 27: 2522-2536
- American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016.Surg Obes Relat Dis. 2018; 14: 259-263
Welbourn R, Small P, Finlay I, Sareela A, Somers S, Mahawar K; for the NBSR data committee. The United Kingdom National Bariatric Surgery Registry Second Registry Report 2014 [monograph on the Internet]. London: The United Kingdom National Bariatric Surgery Registry [cited 2018 Jan 15]. Available from: http://www.bomss.org.uk/nbsr/
- Roux-en-Y gastric bypass versus sleeve gastrectomy as revisional procedures after adjustable gastric band: 5-year outcomes.Obes Surg. 2017; 27: 1430-1437
- Single-stage revision from gastric band to gastric bypass or sleeve gastrectomy: 6- and 12-month outcomes.Surg Endosc. 2016; 30: 2244-2250
- Assessment of perioperative complications following primary bariatric surgery according to the Clavien-Dindo classification: comparison of sleeve gastrectomy and Roux-Y gastric bypass.Surg Endosc. 2016; 30: 273-278
- Safety of revision sleeve gastrectomy compared to Roux-Y gastric bypass after failed gastric banding: analysis of the MBSAQIP.Ann Surg. Epub. 2017 Oct 31;
- Laparoscopic Roux-en-Y gastric bypass patients have an increased lifetime risk of repeat operations when compared to laparoscopic sleeve gastrectomy patients.Surg Endosc. 2016; 30: 1833-1838
- The mesenteric defects in laparoscopic Roux-en-Y gastric bypass: 5 years follow-up of non-closure versus closure using the stapler technique.Surg Endosc. 2017; 31: 3743-3748
- Outcomes after laparoscopic conversion of failed adjustable gastric banding to sleeve gastrectomy or Roux-en-Y gastric bypass.Br J Surg. 2014; 101: 254-260
Article info
Publication history
Published online: July 02, 2018
Accepted:
June 18,
2018
Received in revised form:
June 7,
2018
Received:
February 16,
2018
Identification
Copyright
Crown Copyright © 2018 Published by Elsevier Inc. on behalf of American Society for Bariatric Surgery. All rights reserved.
