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Conversion to Gastric Bypass After Either Failed Gastric Band or Failed Sleeve Gastrectomy

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Abstract

Background

Roux-en-Y gastric bypass (RYGB) is still considered the gold standard in bariatric surgery. Before, adjustable gastric banding (AGB) was regarded as an alternative; nowadays, sleeve gastrectomy (SG) is a more favorable alternative. In case of unsatisfactory results, RYGB is often performed as a secondary procedure. Conversion of an AGB is associated with a high risk of complications; the hypothesis was that this would be less after conversion of an SG.

Methods

All patients undergoing conversion to RYGB after AGB or SG between 2005 and 2012 were included for retrospective analysis. Patient characteristics, operative details, postoperative complications, the relief of complaints, weight loss, reasons for failure, and evolution of known comorbidities up to 2 years were analyzed.

Results

A total of 178 patients were included (79.8 % female): AGB 110 (61.8 %) versus SG 68 (38.2 %). Main reasons for conversion were weight regain/insufficient weight loss (48.4 %) or dysphagia/reflux complaints (39.9 %). Surgical complications were found in 19 patients (AGB 13 vs SG 6; p = 0.530). Infectious complications occurred in 13 patients (AGB 11 vs SG 2; p = 0.135). Total body weight loss was equal between groups after 2 years (AGB 31.6 ± 11.0 % vs SG 31.6 ± 12.0 %; p = 0.998). Similar results were found in a subgroup analysis on patients undergoing conversion for additional weight loss (AGB 31.7 ± 11.7 % vs SG 27.0 ± 13.1 %; p = 0.173).

Conclusions

Conversion to RYGB after failed AGB or SG showed comparable short-term results in terms of postoperative complications and weight loss.

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Authors and Affiliations

  1. Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands

    M. R. van Wezenbeek, T. R. van Oudheusden, J. P. J. G. M. de Zoete, J. F. Smulders & S. W. Nienhuijs

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  1. M. R. van Wezenbeek
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  2. T. R. van Oudheusden
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  3. J. P. J. G. M. de Zoete
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  4. J. F. Smulders
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  5. S. W. Nienhuijs
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Corresponding author

Correspondence to M. R. van Wezenbeek.

Ethics declarations

No ethical approval was required for this study. Permission was granted by the Institutional Review Board for this retrospective study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent was not required. Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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van Wezenbeek, M.R., van Oudheusden, T.R., de Zoete, J.P.J.G.M. et al. Conversion to Gastric Bypass After Either Failed Gastric Band or Failed Sleeve Gastrectomy. OBES SURG 27, 83–89 (2017). https://doi.org/10.1007/s11695-016-2249-2

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  • DOI: https://doi.org/10.1007/s11695-016-2249-2

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