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Mid-term quality of life after gastric band removal and single-stage conversion to gastric bypass: a single-center cohort study

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Abstract

Background

Revision surgeries in patients with failed gastric banding including band removal are increasingly necessary. However, long-term outcomes after band removal alone are unsatisfactory due to weight regain and limited improvement in quality of life. This study aimed to report mid-term quality of life outcomes after gastric band removal and single-stage conversion to Roux-en-Y gastric bypass.

Methods

Data of 108 patients who underwent conversion surgery from 2011 to 2017 were extracted from a prospective database and retrospectively analyzed. During follow-up visits, physical and laboratory data as well as quality of life questionnaires were obtained.

Results

Postoperative mean Moorehead score increased significantly after 1 year (1.62 ± 0.86, p < 0.001) and after 5 years (1.55 ± 0.84, p < 0.001) compared to baseline values (0.72 ± 1.1). The mean follow-up time was 53 months. Moorehead scores at 1, 2, and 5 years postoperative were available in 75% (n = 81), 71% (n = 77), and 42% (n = 45) of cases, respectively. Mixed ANOVA analysis showed a significantly superior increase in Moorehead score in males (p = 0.024). No other significant predictors were identified. Lasting BMI reduction (− 4.6 to 33.0 ± 6.7 kg/m2, p < 0.001) and weight loss (− 12.9% (− 13.6 kg), p < 0.001) 5 years after conversion surgery were seen. Postoperative complications occurred in 35% (n = 38) of patients with a re-operation rate of 30.5% (n = 33).

Conclusion

The current study shows that band removal with single-stage gastric bypass in patients with failed gastric banding leads to a lasting improvement in quality of life and may be the rescue procedure of choice in this setting.

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Author information

Authors and Affiliations

  1. Department of Surgery, Cantonal Hospital Thurgau, Pfaffenholzstrasse 4, CH-8501, Frauenfeld, Switzerland

    M. Pfister, M. P. J. Teuben, P. Probst & M. K. Muller

  2. Department of Traumatology, University Hospital Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland

    H. Teuber

  3. Department of Surgery, Cantonal Hospital Baden, Im Ergel 1, CH-5404, Baden, Switzerland

    A. Nocito

Authors
  1. M. Pfister
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  2. M. P. J. Teuben
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  6. M. K. Muller
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Corresponding author

Correspondence to M. K. Muller.

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Ethics approval

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. Data collection and analysis have been approved by the ethics committee of eastern Switzerland (Project ID: EKOS 21/088, 2021–01261).

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

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Key points

• Conversion from gastric banding to bypass leads to improved quality of life.

• Conversion from gastric banding to bypass shows a lasting weight and BMI reduction.

• Single-stage gastric bypass may be the rescue procedure in failed gastric banding.

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Pfister, M., Teuben, M.P.J., Teuber, H. et al. Mid-term quality of life after gastric band removal and single-stage conversion to gastric bypass: a single-center cohort study. Langenbecks Arch Surg 407, 2755–2762 (2022). https://doi.org/10.1007/s00423-022-02618-1

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  • DOI: https://doi.org/10.1007/s00423-022-02618-1

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