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Surgical Endoscopy

, Volume 30, Issue 12, pp 5453–5458 | Cite as

Safety and efficacy of single-stage conversion of failed adjustable gastric band to laparoscopic Roux-en-Y gastric bypass: a case–control study

  • Kamran SamakarEmail author
  • Travis J. McKenzie
  • James Kaberna
  • Ali Tavakkoli
  • Ashley H. Vernon
  • Arin L. Madenci
  • Scott A. Shikora
  • Malcolm K. Robinson
Article

Abstract

Background

We conducted the following study to evaluate the safety and efficacy of single-stage conversion of failed laparoscopic adjustable gastric band (LAGB) to laparoscopic Roux-en-Y gastric bypass (LRYGB) as compared to a cohort of primary LRYGB patients.

Methods

A single-institution, prospectively maintained bariatric database was used to retrospectively identify consecutive patients who underwent single-stage removal of LAGB with concomitant conversion to LRYGB between the years of 2007 and 2013. The study cohort was matched 1:1 for age, gender, body mass index (BMI), and approximate date of operation to patients who underwent primary LRYGB. Primary endpoints were operative time, complication rate, length of hospital stay (LOS), and percent excess BMI lost (%EBMIL) at 24-month follow-up.

Results

Ninety-four conversion patients met inclusion criteria. There were no statistically significant differences in the mean LOS (3.1 vs. 3.0 days, p = 0.97) or the major complication rate (3.2 vs. 1.1 %, p = 0.62) at 30 days postoperatively. Likewise, 30-day minor complication rates, including readmission, were similar between groups (7.5 vs. 6.4 %, p = 0.77). The average operative time was significantly longer for conversion compared to primary LRYGB (193.5 vs. 132 min; p < 0.01). At most recent follow-up after conversion or primary LRYGB, median %EBMIL was 61.3 and 77.3 % (p < 0.01), percent total weight loss was 23.6 and 30.5 % (p < 0.01), and percent change in BMI was 23.4 and 30.5 % (p < 0.01), respectively. Median follow-up time was 17 and 18.6 months after conversion and primary LRYGB, respectively.

Conclusion

Single-stage conversion of LAGB to LRYGB is safe with an acceptable complication rate and similar LOS compared to primary LRYGB.

Keywords

Gastric banding Revisional surgery Gastric bypass Obesity Outcomes 

Notes

Compliance with ethical standards

Disclosure

Drs. Samakar, McKenzie, Madenci, Tavakkoli, Vernon, Shikora, Robinson and Mr. Kaberna have no conflicts of interest or financial ties to disclose.

Ethical approval

For this type of study (retrospective) formal consent is not required.

Informed consent

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

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Kamran Samakar
    • 1
    Email author
  • Travis J. McKenzie
    • 2
  • James Kaberna
    • 3
  • Ali Tavakkoli
    • 3
  • Ashley H. Vernon
    • 3
  • Arin L. Madenci
    • 4
  • Scott A. Shikora
    • 3
  • Malcolm K. Robinson
    • 3
  1. 1.Department of General and GI SurgeryUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Department of General SurgeryMayo ClinicRochesterUSA
  3. 3.Department of General and GI SurgeryBrigham and Women’s HospitalBostonUSA
  4. 4.Department of UrologyBrigham and Women’s HospitalBostonUSA

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