Niv Pencovich1, Guy Lahat1,2, Orit Goldray2, Subhi Abu-Abeid1,2, Joseph M Klausner1, Shai Meron Eldar3,4. 1. Division of General Surgery, The Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv, Israel. 2. Bariatric Surgery Unit, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv, Israel. 3. Division of General Surgery, The Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv, Israel. shaime@tlvmc.gov.il. 4. Bariatric Surgery Unit, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv, Israel. shaime@tlvmc.gov.il.
Abstract
BACKGROUND: Although considered a common bariatric procedure, laparoscopic adjustable gastric banding (LAGB) is associated with high rates of weight loss failure and long-term complications. PURPOSE: The purpose of this study was to re-assess the safety and outcome of conversion of failed LAGB to laparoscopic sleeve gastrectomy (LSG). MATERIALS AND METHODS: One hundred and nine patients underwent conversion from LAGB to LSG (78 females, mean age 43 ± 11.3 years, mean BMI 42.4 ± 7.4 kg/m2). Patient demographics, obesity-related co-morbidities, BMI before and after the procedure, post-operative complications, and length of hospital stay were documented. RESULTS: All cases were completed laproscopically, with 88% (n = 96) performed in a single stage. Fourteen patients developed early post-operative complications (12.8%), including two leaks and three post-operative bleeding. There were no mortalities in this series. Average BMI at least 1-year following surgery was 33 ± 5.3 kg/m2 (excess weight loss (EWL) = 53.7%). CONCLUSIONS: Our data suggests that conversion of failed LAGB to LSG is both safe and effective. Randomized controlled studies comparing conversion of a failed LAGB to sleeve gastrectomy versus other bariatric operations are necessary to clarify the optimal conversion procedure.
BACKGROUND: Although considered a common bariatric procedure, laparoscopic adjustable gastric banding (LAGB) is associated with high rates of weight loss failure and long-term complications. PURPOSE: The purpose of this study was to re-assess the safety and outcome of conversion of failed LAGB to laparoscopic sleeve gastrectomy (LSG). MATERIALS AND METHODS: One hundred and nine patients underwent conversion from LAGB to LSG (78 females, mean age 43 ± 11.3 years, mean BMI 42.4 ± 7.4 kg/m2). Patient demographics, obesity-related co-morbidities, BMI before and after the procedure, post-operative complications, and length of hospital stay were documented. RESULTS: All cases were completed laproscopically, with 88% (n = 96) performed in a single stage. Fourteen patients developed early post-operative complications (12.8%), including two leaks and three post-operative bleeding. There were no mortalities in this series. Average BMI at least 1-year following surgery was 33 ± 5.3 kg/m2 (excess weight loss (EWL) = 53.7%). CONCLUSIONS: Our data suggests that conversion of failed LAGB to LSG is both safe and effective. Randomized controlled studies comparing conversion of a failed LAGB to sleeve gastrectomy versus other bariatric operations are necessary to clarify the optimal conversion procedure.
Authors: Laurent Biertho; Rudolf Steffen; Ruth Branson; Natascha Potoczna; Thomas Ricklin; Grazyna Piec; Fritz F Horber Journal: Surgery Date: 2005-01 Impact factor: 3.982
Authors: Peter T Hallowell; Thomas A Stellato; David A Yao; Ann Robinson; Margaret M Schuster; Kristen N Graf Journal: Am J Surg Date: 2009-03 Impact factor: 2.565