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Revisions after failed gastric band: sleeve gastrectomy and Roux-en-Y gastric bypass

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Abstract

Introduction

Laparoscopic gastric band is an appealing bariatric operation due to its simplicity and good short-term outcomes; however, it is associated with complications (slippage, erosion, prolapse) and failure in reaching target weight loss. This study describes our experience with failed gastric bands that required a revisional procedure.

Materials and Methods

This single-center retrospective analysis includes all consecutive patients who underwent a gastric band removal and revisional surgery in our hospital from January 2008 to June 2014. A total of 81 patients were identified and divided in three groups: Group one included patients who just had the gastric band removed (43), group two consisted of patients who underwent a conversion to sleeve gastrectomy (SG) (26), and group three included patients who required a conversion to Roux-en Y gastric bypass (RYGB) (12). Patient demographics, date of gastric band placement, indications for revision, postoperative morbidity and mortality, operating time, blood loss, length of stay, and % excess weight loss (%EWL) were recorded. Perioperative and clinical outcomes were compared between conversions to SG and RYGB.

Results

In group two (n = 26), 21 conversions to SG were performed in concurrence with the band removal as a one-stage operation, while five procedures were performed in two-stages. There were no complications and no case was converted to open. Patients who underwent a one-stage procedure had a longer operative time, although it did not reach statistical significance. In group three, 12 patients underwent a conversion to RYGB as a revisional operation; 11 were performed as a one-stage procedure and only one patient underwent a two-stage procedure.

Conclusions

SG and RYGB are safe options to revise a failed gastric band. Both groups who received either a SG or RYGB had a low complication rate and acceptable %EWL with no statistical difference between the two.

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Funding

No grant funding was obtained for this study.

Disclosures

Raquel Gonzalez-Heredia, Mario Masrur, Kristin Patton, Vivek Bindal, Shravan Sarvepalli and Enrique Elli have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. College of Medicine, University of Illinois at Chicago, 840 South Wood Street, 435 E, Chicago, IL, 60612, USA

    Raquel Gonzalez-Heredia, Mario Masrur, Kristin Patton, Vivek Bindal, Shravan Sarvepalli & Enrique Elli

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  1. Raquel Gonzalez-Heredia
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  2. Mario Masrur
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  3. Kristin Patton
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  4. Vivek Bindal
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  5. Shravan Sarvepalli
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  6. Enrique Elli
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Correspondence to Raquel Gonzalez-Heredia.

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Gonzalez-Heredia, R., Masrur, M., Patton, K. et al. Revisions after failed gastric band: sleeve gastrectomy and Roux-en-Y gastric bypass. Surg Endosc 29, 2533–2537 (2015). https://doi.org/10.1007/s00464-014-3995-7

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  • DOI: https://doi.org/10.1007/s00464-014-3995-7

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