Isabelle Debergh1, Barbara Defoort2, Marieke De Visschere3, Silke Flahou1, Sebastiaan Van Cauwenberge1, Jan P Mulier4, Bruno Dillemans1. 1. a Department of Surgery , AZ Sint-Jan Brugge ? Oostende AV, Campus Brugge , Brugge , Belgium. 2. b Department of Surgery , AZ Maria Middelares , Gent , Belgium. 3. c Department of Surgery , AZ Sint-Vincentiusziekenhuis , Deinze , Belgium. 4. d Department of Anesthesia , AZ Sint-Jan Brugge ? Oostende AV, Campus Brugge , Brugge , Belgium.
Abstract
AIMS: To achieve additional weight loss or to resolve band-related problems, a laparoscopic adjustable gastric banding (LAGB) can be converted to a laparoscopic Roux-en-Y gastric bypass (RYGB). There is limited data on the feasibility and safety of routinely performing a single-step conversion. We assessed the efficacy of this revisional approach in a large cohort of patients operated in a high-volume bariatric institution. METHODS: Between October 2004 and December 2015, a total of 885 patients who underwent LAGB removal with RYGB were identified from a prospectively collected database. In all cases, a single-stage conversion procedure was planned. The feasibility of this approach and peri-operative outcomes of these patients were evaluated and analyzed. RESULTS: A single-step approach was successfully achieved in 738 (83.4%) of the 885 patients. During the study period, there was a significant increase in performing the conversion from LAGB to RYGB single-staged. No mortality or anastomotic leakage was observed in both groups. Only 45 patients (5.1%) had a 30-d complication: most commonly hemorrhage (N = 20/45), with no significant difference between the groups. CONCLUSION: Converting a LAGB to RYGB can be performed with a very low morbidity and zero-mortality in a high-volume revisional bariatric center. With increasing experience and full standardization of the conversion, the vast majority of operations can be performed as a single-stage procedure. Only a migrated band remains a formal contraindication for a one-step approach.
AIMS: To achieve additional weight loss or to resolve band-related problems, a laparoscopic adjustable gastric banding (LAGB) can be converted to a laparoscopic Roux-en-Y gastric bypass (RYGB). There is limited data on the feasibility and safety of routinely performing a single-step conversion. We assessed the efficacy of this revisional approach in a large cohort of patients operated in a high-volume bariatric institution. METHODS: Between October 2004 and December 2015, a total of 885 patients who underwent LAGB removal with RYGB were identified from a prospectively collected database. In all cases, a single-stage conversion procedure was planned. The feasibility of this approach and peri-operative outcomes of these patients were evaluated and analyzed. RESULTS: A single-step approach was successfully achieved in 738 (83.4%) of the 885 patients. During the study period, there was a significant increase in performing the conversion from LAGB to RYGB single-staged. No mortality or anastomotic leakage was observed in both groups. Only 45 patients (5.1%) had a 30-d complication: most commonly hemorrhage (N = 20/45), with no significant difference between the groups. CONCLUSION: Converting a LAGB to RYGB can be performed with a very low morbidity and zero-mortality in a high-volume revisional bariatric center. With increasing experience and full standardization of the conversion, the vast majority of operations can be performed as a single-stage procedure. Only a migrated band remains a formal contraindication for a one-step approach.
Authors: Diana Vetter; Dimitri Aristotle Raptis; Mira Giama; Hanna Hosa; Markus K Muller; Antonio Nocito; Marc Schiesser; Rudolf Moos; Marco Bueter Journal: Langenbecks Arch Surg Date: 2017-10-18 Impact factor: 3.445
Authors: A Schäfer; Philipp Gehwolf; J Umlauft; T Dziodzio; M Biebl; A Perathoner; F Cakar-Beck; H Wykypiel Journal: Obes Surg Date: 2019-03 Impact factor: 4.129