M Devadas1,2,3,4,5,6, D J Ku7. 1. Department of Upper Gastrointestinal Surgery and General Surgery, Nepean Hospital, Nepean Blue Mountains Local Health District, Sydney, NSW, Australia. 2. Department of Bariatric Surgery and Upper Gastrointestinal Surgery, Blacktown Hospital Western Sydney Local Health District, Sydney, NSW, Australia. 3. Centre for Bariatric and Metabolic Surgery Circle of Care - Institute of Weight Control, Hospital for Specialist Surgery, Baulkham Hills, Sydney, NSW, Australia. 4. Department of Upper Gastrointestinal Surgery and General Surgery, Nepean Private Hospital Kingswood, Sydney, NSW, Australia. 5. Department of Upper Gastrointestinal Surgery and General Surgery, Norwest Private Hospital Bella Vista, Sydney, NSW, Australia. 6. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. 7. General Surgical Department, Westmead Hospital, Sydney, NSW, Australia. Dominic.joey.ku@gmail.com.
Abstract
BACKGROUND: Bariatric surgery is the most effective treatment for severe obesity, capable of producing more than 50% excess weight loss at 10-year follow-up (James Clin Dermatol 1; 22:276-80; O'Brien Br J Surg 2; 102:611-17; Buchwald et al. Metab Syndr 3; 347-56). The success of bariatric surgery extends far beyond weight loss, with up to 80-90% of patients having improvement or resolution of many of their weight-related co-morbidities including type II diabetes mellitus and hypertension (Puzziferri et al. JAMA 4; 312:934-42; Buchwald et al. Am J Med 5; 122:248-56). However, there is a paucity of data regarding conversional bariatric surgery. OBJECTIVE: This study aims to explore the efficacy, safety and feasibility of conversional surgery. SETTING: This study represents the largest Australasian series focusing on conversional bariatric surgery. The study was conducted in the Norwest Private Hospital and Hospital for Specialist Surgery (HSS), both private Hospitals in Sydney, Australia. METHODS: Data was collected prospectively at regular intervals for more than 12 months from 1 January 2012 to 1st November 2015 for all patients requiring a laparoscopic sleeve gastrectomy (LSG) as secondary procedure after prior laparoscopic adjustable gastric band (LAGB). Excess weight loss (EWL), percentage total body weight loss (TWL) and excess BMI loss (EBMIL) as well as any complications were recorded. RESULTS: There were low rates of morbidity (1.1%) and no mortality at 12-month follow-up. Satisfactory EWL of 60% (95% CI: 56.6-63.4%), EBMIL of 60.1% (95% CI: 48.8-71.4%) and 16% TWL was achieved at 12-month follow-up. CONCLUSION: We therefore conclude that sleeve gastrectomy is a safe and valid option for conversional bariatric surgery following LAGB.
BACKGROUND: Bariatric surgery is the most effective treatment for severe obesity, capable of producing more than 50% excess weight loss at 10-year follow-up (James Clin Dermatol 1; 22:276-80; O'Brien Br J Surg 2; 102:611-17; Buchwald et al. Metab Syndr 3; 347-56). The success of bariatric surgery extends far beyond weight loss, with up to 80-90% of patients having improvement or resolution of many of their weight-related co-morbidities including type II diabetes mellitus and hypertension (Puzziferri et al. JAMA 4; 312:934-42; Buchwald et al. Am J Med 5; 122:248-56). However, there is a paucity of data regarding conversional bariatric surgery. OBJECTIVE: This study aims to explore the efficacy, safety and feasibility of conversional surgery. SETTING: This study represents the largest Australasian series focusing on conversional bariatric surgery. The study was conducted in the Norwest Private Hospital and Hospital for Specialist Surgery (HSS), both private Hospitals in Sydney, Australia. METHODS: Data was collected prospectively at regular intervals for more than 12 months from 1 January 2012 to 1st November 2015 for all patients requiring a laparoscopic sleeve gastrectomy (LSG) as secondary procedure after prior laparoscopic adjustable gastric band (LAGB). Excess weight loss (EWL), percentage total body weight loss (TWL) and excess BMI loss (EBMIL) as well as any complications were recorded. RESULTS: There were low rates of morbidity (1.1%) and no mortality at 12-month follow-up. Satisfactory EWL of 60% (95% CI: 56.6-63.4%), EBMIL of 60.1% (95% CI: 48.8-71.4%) and 16% TWL was achieved at 12-month follow-up. CONCLUSION: We therefore conclude that sleeve gastrectomy is a safe and valid option for conversional bariatric surgery following LAGB.
Authors: J D Halverson; G R Zuckerman; R E Koehler; K Gentry; H E Michael; K DeSchryver-Kecskemeti Journal: Ann Surg Date: 1981-08 Impact factor: 12.969
Authors: Logan T Mellert; Maureen Cheung; Lindsay Berbiglia; Ashley Shoemaker; Deborah Douglas; Mark Pozsgay; John Zografakis; Adrian Dan Journal: Cureus Date: 2020-05-14