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Original article| Volume 14, ISSUE 10, P1516-1520, October 2018

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Single-stage conversions from failed gastric band to sleeve gastrectomy versus Roux-en-Y gastric bypass: results from the United Kingdom National Bariatric Surgical Registry

      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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