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Safety of one-stage conversion surgery after failed gastric band: our experience and review of the literature

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Abstract

The laparoscopic adjustable gastric band (AGB) has fallen out of favor due to poor long-term weight loss and frequent complications. Many patients stand to benefit from elective conversion of AGB to more durable procedures such as sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Whether it is safer to perform this conversion in one or two stages, however, remains controversial. We performed an IRB-approved review of prospectively collected data from all one-stage band conversions performed at our institution from January 2012 to December 2017. Patients were separated into two groups: those who underwent conversion to either a RYGB or SG. Demographics, indications, and outcomes of each group were compared using Fisher’s exact test, Mann–Whitney rank sums, and chi-squared tests. Outcomes were recorded within a 1-year follow-up period and compared to published outcomes for one-stage band conversions. Thirty-eight patients were included for analysis. Average age and BMI were was 50.8 years and 41.1 kg/m2, respectively. The average operative time (164 min, 105–258 min) and length of stay (2.2 days, 1–5 days) did not differ between indication and procedure performed. Overall, early (< 30 day) and late (> 30 day) major complication rates were 7.9% and 5.3%, respectively. There were no leaks and no deaths. Within a 1-year postoperative period, seven re-interventions were performed. Elective one-stage band conversion to RYGB or SG can be performed safely.

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Acknowledgements

Darla Bruchak RN CBN (darla.bruchak@sluhn.org); St Luke’s University Health Network; Bethlehem, PA.

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Authors and Affiliations

  1. St Luke’s University Health Network, Bethlehem, PA, USA

    Peter W. Lundberg, Abigail Gotsch, Leonardo Claros, Jill Stotlzfus & Maher El Chaar

  2. Temple University-Lewis Katz School of Medicine, Philadelphia, PA, USA

    Eonjung Kim

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  1. Peter W. Lundberg
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  2. Abigail Gotsch
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  3. Eonjung Kim
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  4. Leonardo Claros
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  5. Jill Stotlzfus
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  6. Maher El Chaar
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Correspondence to Peter W. Lundberg.

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Conflict of interest

All authors including Peter W Lundberg, Abigail Gotsch, Eonjun Kim, Leonardo Claros, Jill Stoltzfus, and Maher El Chaar have no conflicts of interest to disclose.

Research involving human participants and/or animals

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. For this retrospective study, formal consent is not required.

Informed consent

As this study involved a retrospective review of a prospectively maintained, de-identified database, obtaining informed consent did not apply, and we obtained an exemption from informed consent by our center’s Institutional Review Board.

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Lundberg, P.W., Gotsch, A., Kim, E. et al. Safety of one-stage conversion surgery after failed gastric band: our experience and review of the literature. Updates Surg 71, 445–450 (2019). https://doi.org/10.1007/s13304-018-0598-1

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  • DOI: https://doi.org/10.1007/s13304-018-0598-1

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