Skip to main content
SpringerLink
Log in

Conversion of Laparoscopic Adjustable Gastric Banding to Gastric Bypass: a Comparison to Primary Gastric Bypass

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Introduction

Laparoscopic adjustable gastric banding (LAGB) has a considerable failure rate. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the rescue options. This study aims to compare the complication rates and outcomes between LAGB converted to LRYGB and primary LRYGB.

Materials and Methods

A retrospective analysis was performed in all patients converted from LAGB to LRYGB between January 2007 and March 2017. This group was compared to a matched cohort of primary LRYGB patients operated during the same period. Early and late complications, weight loss, and improvement of comorbidities were analyzed.

Results

One hundred sixty-one revisional LRYGB patients were compared to a similar number of primary LRYGB patients. Preoperative age, gender distribution, weight, and BMI were comparable. Mean operative time was longer in the revisional group (137.7 vs. 112.7 min, respectively, P < 0.001). The overall early complication rates were comparable between the groups (7.5 vs. 11.8%, P = 0.16), including postoperative leak rate (0.62%). Follow-up of at least 6 months was attained in 78% of the patients. Revisional cases demonstrated less weight loss (61.5 vs. 73.5%EWL, respectively, P = 0.004) and slightly less improvement of comorbidities (75.0 vs. 85.7%, respectively, P = 0.09). The late complication rate was comparable (8.1 vs. 8.1%, P = 1.0).

Conclusion

Albeit longer operating time, revision of LAGB to LRYGB is a safe procedure, with similar complication rates when compared to primary LRYGB. Although revisional LRYGB does result in less weight loss than primary LRYGB, the procedure’s safety makes it a very plausible option as a rescue operation for failed LAGB.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mittermair RP, Obermuller S, Perathoner A, et al. Results and complications after Swedish adjustable gastric banding—10 years experience. Obes Surg. 2009;19(12):1636–41. https://doi.org/10.1007/s11695-009-9967-7.

    Article  PubMed  Google Scholar 

  2. Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16(7):829–35. https://doi.org/10.1381/096089206777822359.

    Article  PubMed  CAS  Google Scholar 

  3. Elnahas A, Graybiel K, Farrokhyar F, et al. Revisional surgery after failed laparoscopic adjustable gastric banding: a systematic review. Surg Endosc. 2013;27(3):740–5. https://doi.org/10.1007/s00464-012-2510-2.

    Article  PubMed  Google Scholar 

  4. Altieri MS, Yang J, Telem DA, et al. Lap band outcomes from 19,221 patients across centers and over a decade within the state of New York. Surg Endosc. 2016;30(5):1725–32. https://doi.org/10.1007/s00464-015-4402-8.

    Article  PubMed  Google Scholar 

  5. Tran TT, Pauli E, Lyn-Sue JR, et al. Revisional weight loss surgery after failed laparoscopic gastric banding: an institutional experience. Surg Endosc. 2013;27(11):4087–93. https://doi.org/10.1007/s00464-013-3065-6.

    Article  PubMed  Google Scholar 

  6. Tutuian R. Effects of bariatric surgery on gastroesophageal reflux. Curr Opin Gastroenterol. 2014;30(4):434–8. https://doi.org/10.1097/MOG.0000000000000083.

    Article  PubMed  Google Scholar 

  7. Braghetto I, Csendes A. Prevalence of Barrett’s esophagus in bariatric patients undergoing sleeve gastrectomy. Obes Surg. 2016;26(4):710–4. https://doi.org/10.1007/s11695-015-1574-1.

    Article  PubMed  Google Scholar 

  8. Felsenreich DM, Kefurt R, Schermann M, et al. Reflux, sleeve dilation, and Barrett’s esophagus after laparoscopic sleeve gastrectomy: long-term follow-up. Obes Surg. 2017;08

  9. Ramly EP, Safadi BY, Aridi HD, et al. Concomitant removal of gastric band and gastric bypass: analysis of outcomes and complications from the ACS-NSQIP database. Obes Surg. 2017;27(2):462–8. https://doi.org/10.1007/s11695-016-2348-0.

    Article  PubMed  Google Scholar 

  10. Aarts E, Koehestanie P, Dogan K, et al. Revisional surgery after failed gastric banding: results of one-stage conversion to RYGB in 195 patients. Surg Obes Relat Dis. 2014;10(6):1077–83. https://doi.org/10.1016/j.soard.2014.07.006.

    Article  PubMed  Google Scholar 

  11. Worni M, Ostbye T, Shah A, et al. High risks for adverse outcomes after gastric bypass surgery following failed gastric banding: a population-based trend analysis of the United States. Ann Surg. 2013;257(2):279–86. https://doi.org/10.1097/SLA.0b013e3182683037.

    Article  PubMed  Google Scholar 

  12. Hubbard VS, Hall WH. Gastrointestinal surgery for severe obesity. Obes Surg. 1991;1(3):257–65.

    Article  PubMed  CAS  Google Scholar 

  13. Thereaux J, Veyrie N, Barsamian C, et al. Similar postoperative safety between primary and revisional gastric bypass for failed gastric banding. JAMA Surg. 2014;149(8):780–6. https://doi.org/10.1001/jamasurg.2014.625.

    Article  PubMed  Google Scholar 

  14. Lanthaler M, Aigner F, Kinzl J, et al. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20(8):1078–85. https://doi.org/10.1007/s11695-010-0190-3.

    Article  PubMed  Google Scholar 

  15. Carandina S, Maldonado PS, Tabbara M, et al. Two-step conversion surgery after failed laparoscopic adjustable gastric banding. Comparison between laparoscopic Roux-en-Y gastric bypass and laparoscopic gastric sleeve. Surg Obes Relat Dis. 2014;10(6):1085–91. https://doi.org/10.1016/j.soard.2014.03.017.

    Article  PubMed  Google Scholar 

  16. Jennings NA, Boyle M, Mahawar K, et al. Revisional laparoscopic Roux-en-Y gastric bypass following failed laparoscopic adjustable gastric banding. Obes Surg. 2013;23(7):947–52. https://doi.org/10.1007/s11695-013-0888-0.

    Article  PubMed  CAS  Google Scholar 

  17. Slegtenhorst BR, van der Harst E, Demirkiran A, et al. Effect of primary versus revisional Roux-en-Y gastric bypass: inferior weight loss of revisional surgery after gastric banding. Surg Obes Relat Dis. 2013;9(2):253–8. https://doi.org/10.1016/j.soard.2012.01.022.

    Article  PubMed  Google Scholar 

  18. Delko T, Kostler T, Peev M, et al. Revisional versus primary Roux-en-Y gastric bypass: a case-matched analysis. Surg Endosc. 2014;28(2):552–8. https://doi.org/10.1007/s00464-013-3204-0.

    Article  PubMed  Google Scholar 

  19. 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. https://doi.org/10.1007/s00464-014-3928-5.

    Article  PubMed  CAS  Google Scholar 

  20. Schwarz U, Busettini C, Miles FA. Ocular responses to linear motion are inversely proportional to viewing distance. Science. 1989;245(4924):1394–6. https://doi.org/10.1126/science.2506641.

    Article  PubMed  CAS  Google Scholar 

  21. Yazbek T, Safa N, Denis R, et al. Laparoscopic sleeve gastrectomy (LSG)-a good bariatric option for failed laparoscopic adjustable gastric banding (LAGB): a review of 90 patients. Obes Surg. 2013;23(3):300–5. https://doi.org/10.1007/s11695-012-0825-7.

    Article  PubMed  Google Scholar 

  22. Moon RC, Teixeira AF, Jawad MA. Conversion of failed laparoscopic adjustable gastric banding: sleeve gastrectomy or Roux-en-Y gastric bypass? Surg Obes Relat Dis. 2013;9(6):901–7. https://doi.org/10.1016/j.soard.2013.04.003.

    Article  PubMed  Google Scholar 

  23. Janik MR, Rogula TG, Mustafa RR, et al. Safety of revision sleeve gastrectomy compared to Roux-Y gastric bypass after failed gastric banding: analysis of the MBSAQIP. Ann Surg. 2017;31

  24. Noel P, Schneck AS, Nedelcu M, et al. Laparoscopic sleeve gastrectomy as a revisional procedure for failed gastric banding: lessons from 300 consecutive cases. Surg Obes Relat Dis. 2014;10(6):1116–22. https://doi.org/10.1016/j.soard.2014.02.045.

    Article  PubMed  Google Scholar 

  25. Goitein D, Feigin A, Segal-Lieberman G, et al. Laparoscopic sleeve gastrectomy as a revisional option after gastric band failure. Surg Endosc. 2011;25(8):2626–30. https://doi.org/10.1007/s00464-011-1615-3.

    Article  PubMed  Google Scholar 

  26. Stroh C, Benedix D, Weiner R, et al. Is a one-step sleeve gastrectomy indicated as a revision procedure after gastric banding? Data analysis from a quality assurance study of the surgical treatment of obesity in Germany. Obes Surg. 2014;24(1):9–14. https://doi.org/10.1007/s11695-013-1068-y.

    Article  PubMed  Google Scholar 

  27. Yeung L, Durkan B, Barrett A, et al. Single-stage revision from gastric band to gastric bypass or sleeve gastrectomy: 6- and 12-month outcomes. Surg Endosc. 2016;30(6):2244–50. https://doi.org/10.1007/s00464-015-4498-x.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Abbas Al-Kurd, Ronit Grinbaum, Ala’a Abubeih, Baha Siam, Muhammad Ghanem, Haggi Mazeh, Ido Mizrahi & Nahum Beglaibter

Authors
  1. Abbas Al-Kurd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronit Grinbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ala’a Abubeih
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Baha Siam
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Muhammad Ghanem
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Haggi Mazeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ido Mizrahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nahum Beglaibter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abbas Al-Kurd.

Ethics declarations

The study was approved by our institution’s ethics review board. Due to the retrospective nature of the investigation, no informed patient consent was required. All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al-Kurd, A., Grinbaum, R., Abubeih, A. et al. Conversion of Laparoscopic Adjustable Gastric Banding to Gastric Bypass: a Comparison to Primary Gastric Bypass. OBES SURG 28, 1519–1525 (2018). https://doi.org/10.1007/s11695-017-3047-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-017-3047-1

Keywords

Search

Navigation