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Five-year outcomes of revisional bariatric surgery: gastric band to sleeve gastrectomy or to Roux-en-Y gastric bypass

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Abstract

Background

Revisional bariatric surgery after an index adjustable gastric band (AGB) may be indicated to remedy weight relapse or band-related complications. We examined outcomes five years following revision from AGB to laparoscopic sleeve gastrectomy (AGB-LSG) or to Roux-en-Y gastric bypass (AGB-RYGB).

Methods

We conducted a retrospective review to identify patients (men and women, age 18–80) who underwent one revisional bariatric procedure with AGB as the index procedure at two medical centers in our healthcare system between January 2012 and February 2017. We only included patients with a pre-revision BMI > 30 kg/m2 for whom 5-year follow-up data were available. We compared 5-year weight loss and remission of comorbidities in patients undergoing AGB-LSG and AGB-RYGB conversion.

Results

A total of 114 patients met inclusion criteria (65 AGB-LSG, 49 AGB-RYGB). At 5-year post-revision, percent total weight loss (3.4% vs 19.9%; p < 0.001), percent excess weight loss (7.0% vs 50.8%; p < 0.001) and decrease in BMI (1.5 vs 8.8; p < 0.001) was greater in AGB-RYGB vs. AGB-LSG. No significant difference in remission or development of new comorbidities was observed.

Conclusion

Conversion of AGB to RYGB is associated with superior intermediate-term weight loss compared to conversion of AGB to LSG. Future multicenter studies with larger sample sizes are necessary to further describe the intermediate-term outcomes of revisional bariatric surgery.

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Acknowledgements

We acknowledge Jane Sweeney APRN and Meagan Moskowitz RN for their contributions to this project.

Funding

This project was unfunded.

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Authors and Affiliations

  1. Hartford Healthcare Surgical Weight Loss Center, Hartford, CT, 06102, USA

    Joseph Carbonaro, Richard Seip, Connie Santana, Darren Tishler & Pavlos Papasavas

  2. Department of Surgery, Hartford Hospital, Hartford, CT, 06102, USA

    Tara McLaughlin

  3. Hartford Healthcare Research Program, Hartford, CT, 06102, USA

    Ilene Staff, Yin Wu & Dale Bond

  4. Medical Group Department of Bariatrics, Hartford Healthcare, Meriden, CT, 06450, USA

    Aziz Benbrahim

Authors
  1. Joseph Carbonaro
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  2. Tara McLaughlin
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  3. Richard Seip
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  6. Connie Santana
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  10. Pavlos Papasavas
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Correspondence to Pavlos Papasavas.

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Disclosures

Darren Tishler and Aziz Benbrahim serve as consultants for Medtronic. Joseph Carbonaro, Tara McLaughlin, Richard Seip, Ilene Staff, Yin Wu, Connie Santana, Dale Bond and Pavlos Papasavas have no conflicts of interest to disclose.

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Carbonaro, J., McLaughlin, T., Seip, R. et al. Five-year outcomes of revisional bariatric surgery: gastric band to sleeve gastrectomy or to Roux-en-Y gastric bypass. Surg Endosc (2024). https://doi.org/10.1007/s00464-024-10764-4

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