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Efficacy and Safety of Sleeve Gastrectomy or One Anastomosis Gastric Bypass Conversion Following Adjustable Gastric Banding

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Abstract

Background

Given revision or conversion surgery is required in up to 60% of patients who had adjustable gastric band (LAGB), we compared safety and efficacy of sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB) as conversion surgical procedures in patients with suboptimal response or weight recurrence following LAGB.

Methods

Conversion surgery was performed in 335 patients between 2016 and 2020. Weight loss, early and late-stage complications, and comorbidity outcomes were reviewed and analyzed.

Results

One hundred and sixty-three patients underwent cSG (BMI: 38.3 ± 8.3 kg/m2), and 172 patients underwent cOAGB (BMI: 45.2 ± 9.3 kg/m2). Percent total body weight loss (%TWL) was 28.7 ± 9.9% at 12 months, 30.3 ± 12.8% at 2 years, 31.0 ± 14.5% at 3 years, and 31.1 ± 14.7% at 4 years following OAGB, which was significantly higher than SG; 18.4 ± 8.7%, 18.8 ± 9.8%, 19.3 ± 11.1%, and 16.9 ± 10.9%, respectively (p < 0.0001). Remission of comorbidities, regardless of conversion procedure type, was 20.8% for hypertension (HT), 52% for dyslipidemia (DLD), 60% for type 2 diabetes (DM), 64% for non-alcoholic steatohepatitis (NASH), and 76% for insulin resistance (IR).There were no leaks or deaths following SG or OAGB. A twofold greater frequency of complications was seen in the OAGB group vs SG group (15.1% and 6.7%, respectively).

Conclusion

Significant weight loss, acceptable complication rates, and similar remission of comorbidities were seen regardless of the type of conversion procedure. Prospective randomized clinical trials are recommended for further elucidation of long-term outcomes.

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Data Availability

Due to confidentiality and sensitivity of the clinical data, data that support the findings of this study are available from the corresponding author (Mojgan Nazari), upon reasonable request.

References

  1. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19(12):1605–11. https://doi.org/10.1007/s11695-009-0014-5.

    Article  Google Scholar 

  2. Backman B, Brown D, Cottrell J, Campbell A, Clancy W, Halim Shah Y J C, et al. Bariatric Surgery Registry 2020/2021 Annual Report.; 2022.

  3. Cobourn C, Chapman MA, Ali A, et al. Five-year weight loss experience of outpatients receiving laparoscopic adjustable gastric band surgery. Obes Surg. 2013;23(7):903–10. https://doi.org/10.1007/s11695-013-0881-7.

    Article  Google Scholar 

  4. Chansaenroj P, Aung L, Lee WJ, et al. Revision procedures after failed adjustable gastric banding: comparison of efficacy and safety. Obes Surg. 2017;27(11):2861–7. https://doi.org/10.1007/s11695-017-2716-4.

    Article  Google Scholar 

  5. Devadas M, Ku DJ. Conversional weight loss surgery: an Australian experience of converting laparoscopic adjustable gastric bands to laparoscopic sleeve gastrectomy. Obes Surg. 2018;28(7):1902–9. https://doi.org/10.1007/s11695-018-3128-9.

    Article  CAS  Google Scholar 

  6. Mahawar KK, Himpens J, Shikora SA, et al. The first consensus statement on one anastomosis/mini gastric bypass (OAGB/MGB) using a modified Delphi approach. Obes Surg. 2018;28(2):303–12. https://doi.org/10.1007/s11695-017-3070-2.

    Article  Google Scholar 

  7. Marti-Fernandez R, Cassinello-Fernandez N, Cuenca-Ramirez MD, et al. Roux-en-Y Gastric bypass as an effective bariatric revisional surgery after restrictive procedures. Obes Facts. 2020;13(3):367–74. https://doi.org/10.1159/000507710.

    Article  Google Scholar 

  8. Amiki M, Seki Y, Kasama K, et al. Revisional bariatric surgery for insufficient weight loss and gastroesophageal reflux disease: our 12-year experience. Obes Surg. 2020;30(5):1671–8. https://doi.org/10.1007/s11695-019-04374-6.

    Article  Google Scholar 

  9. Zhang L, Tan WH, Chang R, et al. Perioperative risk and complications of revisional bariatric surgery compared to primary Roux-en-Y gastric bypass. Surg Endosc. 2015;29(6):1316–20. https://doi.org/10.1007/s00464-014-3848-4.

    Article  Google Scholar 

  10. Musella M, Bruni V, Greco F, et al. Conversion from laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) to one anastomosis gastric bypass (OAGB): preliminary data from a multicenter retrospective study. Surgery for Obesity and Related Diseases. 2019;15(8):1332–9. https://doi.org/10.1016/j.soard.2019.05.026.

    Article  Google Scholar 

  11. Pujol Rafols J, al Abbas AI, Devriendt S, Guerra A, Herrera MF, Himpens J, et al. Roux-en-Y gastric bypass, sleeve gastrectomy, or one anastomosis gastric bypass as rescue therapy after failed adjustable gastric banding: a multicenter comparative study. Surgery for Obesity and Related Diseases. 2018;14(11):1659-1666. https://doi.org/10.1016/j.soard.2018.08.005

  12. Riaz A, Singh K, Askari A, et al. Comparison of outcomes of laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass after failed gastric banding. Obesity and overweight. 2020;6(1):2455–7633.

    Google Scholar 

  13. Berende CAS, De Zoete JP, Smulders JF, et al. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4. https://doi.org/10.1007/s11695-011-0501-3.

    Article  Google Scholar 

  14. Cheema F, Choi M, Moran-Atkin E, et al. Outcomes in revisional bariatric surgery: a high-volume single institution experience. Surg Endosc. 2021;35(7):3932–9. https://doi.org/10.1007/s00464-020-07855-3.

    Article  Google Scholar 

  15. Coblijn UK, Verveld CJ, Van Wagensveld BA, et al. Laparoscopic roux-En-Y gastric bypass or laparoscopic sleeve gastrectomy as revisional procedure after adjustable gastric band - a systematic review. Obes Surg. 2013;23(11):1899–914. https://doi.org/10.1007/s11695-013-1058-0.

    Article  Google Scholar 

  16. Foletto M, Prevedello L, Bernante P, et al. Sleeve gastrectomy as revisional procedure for failed gastric banding or gastroplasty. Surgery for Obesity and Related Diseases. 2010;6(2):146–51. https://doi.org/10.1016/j.soard.2009.09.003.

    Article  Google Scholar 

  17. Pereira A, Pinho AC, Sousa HS, da Costa EL, Rodrigues S, Barbosa E, Preto J. How far can our expectations go on revisional bariatric surgery after failed adjustable gastric banding? Obesity Surgery. 2021;31(4):1603-1611. https://doi.org/10.1007/s11695-020-05167-y

  18. Weber M, Müller MK, Michel JM, et al. Laparoscopic Roux-en-Y Gastric Bypass, but not rebanding, should be proposed as rescue procedure for patients with failed laparoscopic gastric banding. Ann Surg. 2003;238(6):827–34. https://doi.org/10.1097/01.sla.0000098623.53293.bb.

    Article  Google Scholar 

  19. Janik M, Ibikunle C, Khan A, et al. Safety of single stage revision laparoscopic sleeve gastrectomy compared to laparoscopic Roux-Y Gastric bypass after failed gastric banding. Obes Surg. 2021;31(2):588–96. https://doi.org/10.1007/s11695-020-04975-6.

    Article  Google Scholar 

  20. 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. https://doi.org/10.1007/s13304-015-0335-y.

    Article  Google Scholar 

  21. Chiappetta S, Stier C, Scheffel O, et al. Mini/one anastomosis gastric bypass versus Roux-en-Y gastric bypass as a second step procedure after sleeve gastrectomy—a retrospective cohort study. Obes Surg. 2019;29(3):819–27. https://doi.org/10.1007/s11695-018-03629-y.

    Article  Google Scholar 

  22. Kermansaravi M, Shahmiri SS, DavarpanahJazi AH, et al. One anastomosis/mini-gastric bypass (OAGB/MGB) as revisional surgery following primary restrictive bariatric procedures: a systematic review and meta-analysis. Obes Surg. 2021;31(1):370–83. https://doi.org/10.1007/s11695-020-05079-x.

    Article  Google Scholar 

  23. De Luca M, Piatto G, Merola G, et al. IFSO update position statement on one anastomosis gastric bypass (OAGB). Obes Surg. 2021;31(7):3251–78. https://doi.org/10.1007/s11695-021-05413-x.

    Article  Google Scholar 

  24. Poublon N, Chidi I, Bethlehem M, Kuipers E, Gadiot R, Emous M, et al. 2020 One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery. Obesity Surgery 30, 9, (3287–3294), https://doi.org/10.1007/s11695-020-04536-x)

  25. Pujol-Rafols J, Al Abbas AI, Devriendt S, et al. Conversion of adjustable gastric banding to Roux-en-Y gastric bypass in one or two steps: what is the best approach? Analysis of a multicenter database concerning 832 patients. Obes Surg. 2020;30(12):5026–32. https://doi.org/10.1007/s11695-020-04951-0.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Sydney Bariatric Clinic, Westmead, New South Wales, 2145, Australia

    Mojgan Nazari, Carolyn Jameson, Brendan Ryan & Anthony Brancatisano

  2. Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, 2145, Australia

    Mojgan Nazari

  3. School of Medicine, University of Notre Dame, Darlinghurst, New South Wales, 2010, Australia

    Carolyn Jameson

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  1. Mojgan Nazari
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Correspondence to Mojgan Nazari.

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Ethical Approval

All procedures performed in this study were in accordance with ethical standards of the institutional and/or national health research committee and with the 1964 Helsinki Declaration and its later amendments of comparable ethical standards.

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Informed consent was obtained from all individuals included in the study.

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Key Points

• Conversion LSG and OAGB will result in significant weight loss after LAGB.

• Conversion bariatric surgeries are beneficial for patients with comorbidities.

• Conversion to a OAGB was associated with greater weight loss but at a higher rate of morbidity than LSG.

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Nazari, M., Jameson, C., Ryan, B. et al. Efficacy and Safety of Sleeve Gastrectomy or One Anastomosis Gastric Bypass Conversion Following Adjustable Gastric Banding. OBES SURG 33, 426–433 (2023). https://doi.org/10.1007/s11695-022-06374-5

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  • DOI: https://doi.org/10.1007/s11695-022-06374-5

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