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Revision Procedures After Failed Adjustable Gastric Banding: Comparison of Efficacy and Safety

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Abstract

Background

Laparoscopic adjustable gastric banding (LAGB) was one of the commonly performed bariatric operations; however, it carries a high revision rate. The aim of the present study was to report the long-term outcomes of LAGB and compare the outcomes between the different revision procedures.

Methods

All patients who underwent LAGB in a large bariatric center in Asia between May 2002 and April 2011 were included. Interval between primary LAGB to the revision operation, the reason and type of revision surgery were identified and analyzed.

Results

A total of 275 consecutive patients were included. All of the procedures were completed laparoscopically with no major complications. The percentage of excess weight loss (%EWL) at 10-year follow-up was 45%. In this study, 53 patients (19.3%) had revision surgery, including with 26 single anastomosis (mini-) gastric bypass (R-LSAGB) (49%), 17 sleeve gastrectomy (R-LSG) (32.1%), 9 Roux-en-Y gastric bypass (R-LRYGB) (17%), and 1 other procedure (1.9%). A major complication occurred in 6 patients (11.3%). All of the follow-up patients with revision surgeries had %EWL > 50% at the 2-year follow-up. R-LSAGB patients achieved better weight loss than those who underwent R-LSG and R-LRYGB (p = 0.001).

Conclusions

The long-term result for weight loss after LAGB is unsatisfactory. The revision of failed LAGB to other bariatric surgeries is safe and can be performed in one stage with a low complication rate. Patients who underwent R-LSAGB had better weight loss results than the R-LSG or R-LRYGB patients.

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References

  1. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  2. Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery. 2004;135(3):326–51.

    Article  PubMed  Google Scholar 

  3. Spivak H, Abdelmelek MF, Beltran OR, et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26(7):1909–19.

    Article  PubMed  Google Scholar 

  4. Zuegel NP, Lang RA, Huttl TP, et al. Complications and outcome after laparoscopic bariatric surgery: LAGB versus LRYGB. Langenbeck's Arch Surg. 2012;397(8):1235–41.

    Article  Google Scholar 

  5. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  PubMed  Google Scholar 

  6. Van Nieuwenhove Y, Ceelen W, Stockman A, et al. Long-term results of a prospective study on laparoscopic adjustable gastric banding for morbid obesity. Obes Surg. 2011;21(5):582–7.

    Article  CAS  PubMed  Google Scholar 

  7. Lee WJ, Wang W, Wei PL, et al. Weight loss and improvement of obesity-related illness following laparoscopic adjustable gastric banding procedure for morbidly obese patients in Taiwan. J Formos Med Assoc. 2006;105(11):887–94.

    Article  PubMed  Google Scholar 

  8. Victorzon M, Tolonen P. Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity. Surg Obes Relat Dis. 2013;9(5):753–7.

    Article  PubMed  Google Scholar 

  9. Aarts EO, Dogan K, Koehestanie P, et al. What happens after gastric band removal without additional bariatric surgery? Surg Obes Relat Dis. 2014;10(6):1092–6.

    Article  PubMed  Google Scholar 

  10. Kirshtein B, Kirshtein A, Perry Z, et al. Laparoscopic adjustable gastric band removal and outcome of subsequent revisional bariatric procedures: a retrospective review of 214 consecutive patients. Int J Surg. 2016;27:133–7.

    Article  PubMed  Google Scholar 

  11. Westling A, Ohrvall M, Gustavsson S. Roux-en-Y gastric bypass after previous unsuccessful gastric restrictive surgery. J Gastrointest Surg. 2002;6(2):206–11.

    Article  PubMed  Google Scholar 

  12. Carr WR, Jennings NA, Boyle M, et al. A retrospective comparison of early results of conversion of failed gastric banding to sleeve gastrectomy or gastric bypass. Surg Obes Relat Dis. 2015;11(2):379–84.

    Article  PubMed  Google Scholar 

  13. Roller JE, Provost DA. Revision of failed gastric restrictive operations to Roux-en-Y gastric bypass: impact of multiple prior bariatric operations on outcome. Obes Surg. 2006;16(7):865–9.

    Article  PubMed  Google Scholar 

  14. Bruzzi M, Voron T, Zinzindohoue F, et al. Revisional single-anastomosis gastric bypass for a failed restrictive procedure: 5-year results. Surg Obes Relat Dis. 2016;12(2):240–5.

    Article  PubMed  Google Scholar 

  15. Piazza L, Di Stefano C, Ferrara F, et al. Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients. Updat Surg. 2015;67(4):433–7.

    Article  Google Scholar 

  16. Abu-Gazala S, Keidar A. Conversion of failed gastric banding into four different bariatric procedures. Surg Obes Relat Dis. 2012;8(4):400–7.

    Article  PubMed  Google Scholar 

  17. Poyck PP, Polat F, Gouma DJ, et al. Is biliopancreatic diversion with duodenal switch a solution for patients after laparoscopic gastric banding failure? Surg Obes Relat Dis. 2012;8(4):393–9.

    Article  CAS  PubMed  Google Scholar 

  18. Kasama K, Mui W, Lee WJ, et al. IFSO-APC consensus statements 2011. Obes Surg. 2012;22(5):677–84.

    Article  PubMed  Google Scholar 

  19. Carelli AM, Youn HA, Kurian MS, et al. Safety of the laparoscopic adjustable gastric band: 7-year data from a U.S. center of excellence. Surg Endosc. 2010;24(8):1819–23.

    Article  PubMed  Google Scholar 

  20. Favretti F, Segato G, Ashton D, et al. Laparoscopic adjustable gastric banding in 1,791 consecutive obese patients: 12-year results. Obes Surg. 2007;17(2):168–75.

    Article  PubMed  Google Scholar 

  21. Schouten R, Wiryasaputra DC, van Dielen FM, et al. Long-term results of bariatric restrictive procedures: a prospective study. Obes Surg. 2010;20(12):1617–26.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.

    Article  PubMed  Google Scholar 

  23. Lin YH, Lee WJ, Ser KH, et al. 15-year follow-up of vertical banded gastroplasty: comparison with other restrictive procedures. Surg Endosc. 2016;30:489–94.

    Article  PubMed  Google Scholar 

  24. Chiapaikeo, D., M. Schultheis, B. Protyniak, et al., Analysis of reoperations after laparoscopic adjustable gastric banding. JSLS, 2014. 18(4).

  25. Tog CH, Halliday J, Khor Y, et al. Evolving pattern of laparoscopic gastric band access port complications. Obes Surg. 2012;22(6):863–5.

    Article  PubMed  Google Scholar 

  26. Emous M, Apers J, Hoff C, et al. Conversion of failed laparoscopic adjustable gastric banding to Roux-en-Y gastric bypass is safe as a single-step procedure. Surg Endosc. 2015;29(8):2217–23.

    Article  CAS  PubMed  Google Scholar 

  27. Berende CA, de Zoete JP, Smulders JF, et al. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4.

    Article  PubMed  Google Scholar 

  28. Dang JT, Switzer NJ, Wu J, et al. Gastric band removal in revisional bariatric surgery, one-step versus two-step: a systematic review and meta-analysis. Obes Surg. 2016;26:866–73.

    Article  PubMed  Google Scholar 

  29. Lee WJ, Ser KH, Lee YC, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012 Dec;22(12):1827–34.

    Article  PubMed  Google Scholar 

  30. Lee WJ, Wang W, Lee YC, et al. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008;18(3):294–9.

    Article  PubMed  Google Scholar 

  31. Utech M, Shaheen H, Halter J, et al. Sleeve gastrectomy as a revision procedure for failed gastric banding. Zentralbl Chir. 2014;139(1):79–82.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan

    Pawan Chansaenroj, Lwin Aung, Wei-Jei Lee, Shu Chun Chen, Jung-Chien Chen & Kong-Han Ser

  2. Department of Surgery, Somdech Phra Pinklao (Royal Thai Naval) Hospital, Bangkok, Thailand

    Pawan Chansaenroj

  3. Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Pawan Chansaenroj

  4. Ng Teng Fong General Hospital, Singapore, Singapore

    Lwin Aung

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  1. Pawan Chansaenroj
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  2. Lwin Aung
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  3. Wei-Jei Lee
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  4. Shu Chun Chen
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  5. Jung-Chien Chen
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  6. Kong-Han Ser
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Correspondence to Wei-Jei Lee.

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The authors declare that they have no conflict of interest.

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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.

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This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study, formal consent is not required. Informed consent does not apply to this submission.

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Chansaenroj, P., Aung, L., Lee, WJ. et al. Revision Procedures After Failed Adjustable Gastric Banding: Comparison of Efficacy and Safety. OBES SURG 27, 2861–2867 (2017). https://doi.org/10.1007/s11695-017-2716-4

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  • DOI: https://doi.org/10.1007/s11695-017-2716-4

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