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Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients

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Abstract

Although laparoscopic adjustable gastric banding (LAGB) has been found to be a generally successful weight loss operation, many patients require revision for weight regain, mechanical complications or intolerance to restriction. We report our experience with laparoscopic mini-gastric bypass (LMGB) as a revisional procedure for failed primary LAGB. From June 2007 to November 2012, 48 patients, who had undergone LAGB, underwent revisional surgery to LMGB. Patient demographics, reasons for band removal, interval between removal and LMGB, operative times, complications, change in comorbidities, and weight loss were collected. The revisions to a mini-gastric bypass (MGB) were completed laparoscopically in all cases except in four, when the MGB was deferred because of gastric tube damage. Mean age was 38 years (range 20–59) and BMI was 43.4 ± 4.2 kg/m2; 82 % of patients were females. Revision was performed after a mean of 28.6 months. The mean hospital stay was 3.25 days. Within 60 days of the MGB, mortality and morbidity were nil. We observed a significant difference in mean BMI after 6 months’ follow-up (P < 0.001). Diabetes remission was observed in 88 % of patients, apnea remission in 66 %, and hypertension remission in 66 % after LMGB (p < 0.001). Moreover, four patients with GERD were cured. All LAGB patients had positive outcomes after the conversion to MGB, with a mean gain of 1.7 points in the bariatric analysis and reporting outcome system questionnaire. Our results suggested that LMGB is a safe, feasible, effective and easy-to-perform revisional procedure for failed LAGB.

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Authors and Affiliations

  1. General and Emergency Surgery Department, Garibaldi Hospital, Catania, Italy

    Luigi Piazza, Carla Di Stefano, Francesco Ferrara & Angelo Bellia

  2. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

    Marco Vacante

  3. Department of Surgery, Vittorio Emanuele Hospital, University of Catania, Via Plebiscito, 628, 95124, Catania, Italy

    Antonio Biondi

Authors
  1. Luigi Piazza
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  2. Carla Di Stefano
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  3. Francesco Ferrara
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  4. Angelo Bellia
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  5. Marco Vacante
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  6. Antonio Biondi
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Correspondence to Marco Vacante.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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No animals but only human participants were engaged in our study.

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Informed consent was obtained from all individual participants included in the study.

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Piazza, L., Di Stefano, C., Ferrara, F. et al. Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients. Updates Surg 67, 433–437 (2015). https://doi.org/10.1007/s13304-015-0335-y

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  • DOI: https://doi.org/10.1007/s13304-015-0335-y

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