Surgical Endoscopy

, Volume 27, Issue 11, pp 4305–4312

Long-term follow-up evaluation of revisional gastric bypass after failed adjustable gastric banding

  • Alexander Perathoner
  • Matthias Zitt
  • Monika Lanthaler
  • Johann Pratschke
  • Matthias Biebl
  • Reinhard Mittermair
Article

DOI: 10.1007/s00464-013-3047-8

Cite this article as:
Perathoner, A., Zitt, M., Lanthaler, M. et al. Surg Endosc (2013) 27: 4305. doi:10.1007/s00464-013-3047-8

Abstract

Background

Disappointing long-term results, frequent band failure, and high rates of band-related complications increasingly necessitate revisional surgery after adjustable gastric banding. Laparoscopic conversion to gastric bypass has been recommended as the procedure of choice. This single-center retrospective study aimed to evaluate the long-term results of revisional gastric bypass after failed adjustable gastric banding.

Methods

The study included 108 consecutive patients who underwent laparoscopic conversion of gastric banding to gastric bypass from 2002 to 2012. Indications for surgery, operative data, weight development, morbidity, and mortality were analyzed. The median follow-up period was 3.4 years (maximum, 10 years).

Results

The most common indications for band removal were band migration, insufficient weight loss, and pouch dilation. The median interval between gastric banding and gastric bypass was 6.6 years. In 52 % of the cases, band removal and gastric bypass surgery were performed simultaneously as a single-stage laparoscopic procedure. The early postoperative morbidity rate was 10.2 %. The body mass index before gastric banding (43.3 kg/m2) decreased significantly to 37.9 kg/m2 before gastric bypass and to 28.8 kg/m2 5 years after gastric bypass.

Conclusions

This is the first report on the long-term outcome after conversion of failed adjustable gastric banding to gastric bypass. Findings have shown revisional gastric bypass to be a feasible bariatric procedure particularly for patients with insufficient weight loss that guarantees a constant and long-lasting weight loss.

Keywords

Band failure Band removal Gastric banding Gastric bypass Long-term outcome Revisional bariatric surgery

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Alexander Perathoner
    • 1
  • Matthias Zitt
    • 1
  • Monika Lanthaler
    • 2
  • Johann Pratschke
    • 1
  • Matthias Biebl
    • 1
  • Reinhard Mittermair
    • 1
  1. 1.Department of Visceral, Transplant, and Thoracic SurgeryInnsbruck Medical UniversityInnsbruckAustria
  2. 2.Department of Plastic, Reconstructive, and Aesthetic SurgeryInnsbruck Medical UniversityInnsbruckAustria