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Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy as Revisional Procedures after Adjustable Gastric Band: 5-Year Outcomes

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Abstract

Introduction

In 2013, a worldwide bariatric surgery survey showed that laparoscopic adjustable gastric banding (LAGB) has been abandoned in favor of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-y gastric bypass (LRYGBP).

Purpose

The aim of this study was to compare results of LRYGBP and LSG performed as a revisional procedure after LAGB.

Materials and Methods

All patients converted from LAGB to LSG or to LRYGBP from January 2007 to December 2011 were included in the study. Clinical data collected were age, gender, indications for revision, complications, body mass index (BMI), and body weight at revisional procedures. Weight loss was calculated at 1, 3, and 5 years after conversion.

Results

Fifty-one patients were included in this study, 43 females and 8 males. Twenty-four patients were converted to LRYGBP (LRYGBP group) and 27 to LSG (LSG group). Indication for conversion was weight loss failure in 34 (67%) patients and band complications in 17 (33%) patients. No significant difference in age, BMI, and body weight in the two groups was found at the time of revision. One patient converted to LRYGBP had an internal hernia; one patient initially scheduled for LSG was intraoperatively converted to LRYGBP due to staple line leak. No other major perioperative complication was observed. Follow-up rate at 5 years was 84.3% (43 patients out of 51 patients) Delta-BMI and percentage of excess weight loss (%EWL) were not significantly different in the two groups at 1, 3, and 5 years (p > 0.05).

Conclusion

LRYGBP or LSG are feasible and effective surgical options after LAGB. Satisfactory weight loss was achieved after both procedures.

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Author information

Authors and Affiliations

  1. General and Endoscopic Surgery Unit, San Giovanni Bosco Hospital, Naples, Italy

    Luigi Angrisani

  2. Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy

    Ariola Hasani

  3. Department of Endocrinology, Gastroenterology and Surgery, University Hospital of Naples “Federico II”, Naples, Italy

    Antonio Vitiello

  4. Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Salerno, Italy

    Antonella Santonicola & Paola Iovino

  5. Thoracic and Abdominal Surgery Department, Montebelluna-Treviso Hospital, Montebelluna, Italy

    Maurizio De Luca

Authors
  1. Luigi Angrisani
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  2. Antonio Vitiello
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  3. Antonella Santonicola
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  4. Ariola Hasani
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  5. Maurizio De Luca
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  6. Paola Iovino
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Correspondence to Antonio Vitiello.

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The authors declare that they have no conflict of interest.

Ethical 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.”

Informed Consent

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

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No grant was provided to authors for the present study.

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Angrisani, L., Vitiello, A., Santonicola, A. et al. Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy as Revisional Procedures after Adjustable Gastric Band: 5-Year Outcomes. OBES SURG 27, 1430–1437 (2017). https://doi.org/10.1007/s11695-016-2502-8

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  • DOI: https://doi.org/10.1007/s11695-016-2502-8

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