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Laparoscopic Sleeve Gastrectomy Following Failed Laparoscopic Adjustable Gastric Banding—a Comparison Between One- and two-Stage Procedures, an Israeli National Database Study

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Abstract

Purpose

The optimal revisional bariatric surgery procedure following a previous failed gastric band surgery is yet to be determined. The aim of our study was to compare single- and two-stage laparoscopic sleeve gastrectomy (LSG) following laparoscopic adjustable gastric banding (LAGB) in terms of short- and mid-term outcomes.

Materials and Methods

Patients who underwent LSG after a failed LAGB in Israel during 2014–2017 were included. Data were obtained from the Israeli National Bariatric Surgery Registry. Data analyzed included comorbidities, postoperative complications, and anthropometric outcomes.

Results

Of 595 patients included in the data analysis, 381 (64%) underwent one-stage and 214 (36%) had two-stage LSG. No differences were observed between the groups in complication rates (5.0 vs. 5.1%, p=0.93). Percent of total weight loss was lower following one-stage than two-stage procedure at both 6 months (19.3±9.3 vs. 21.5±8.1%; p=0.02) and 1 year postoperative (24.9±10.4 vs. 27.8±9.9%; p=0.02). No difference was observed in the percent excess weight loss (51 vs. 56%; p=0.34 and 66 vs. 72%; p=0.38, at 6 months and 12 months postoperative, respectively). In a regression analysis, percent excess weight loss was greater in the two-stage procedure (p=0.02), with no difference in the complication rates (p=0.98).

Conclusion

Single-step LSG had a similar safety profile as two-stage LSG following a failed LAGB. Better weight loss was seen following two-stage LSG. Further prospective studies should investigate long-term follow-up after one- and two-stage procedure.

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References

  1. Bult MJ, van Dalen T, Muller AF. Surgical treatment of obesity. Eur J Endocrinol. 2008;158(2):135–45.

    Article  CAS  Google Scholar 

  2. English WJ, DeMaria EJ, Hutter MM, et al. American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis. 2020;16:457–63.

    Article  Google Scholar 

  3. Welbourn R, Pournaras DJ, Dixon J, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Second IFSO Global Registry Report 2013-2015. Obes Surg. 2018;28(2):313–22.

    Article  Google Scholar 

  4. Cunneen SA. Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding. Surg Obes Relat Dis. 2008;4(3 Suppl):S47–55.

    Article  Google Scholar 

  5. Cunneen SA, Phillips E, Fielding G, et al. Studies of Swedish adjustable gastric band and Lap-Band: systematic review and meta-analysis. Surg Obes Relat Dis. 2008;4(2):174–85.

    Article  Google Scholar 

  6. Phillips E, Ponce J, Cunneen SA, et al. Design and demography of the United States Swedish Adjustable Gastric Band trial: a 3-year prospective study. Surg Obes Relat Dis. 2008;4(3):S63–72.

    Article  Google Scholar 

  7. Ponce J, Nguyen NT, Hutter M, et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011-2014. Surg Obes Relat Dis. 2015;11(6):1199–200.

    Article  Google Scholar 

  8. Arapis K, Tammaro P, Parenti LR, et al. Long-term results after laparoscopic adjustable gastric banding for morbid obesity: 18-year follow-up in a single university unit. Obes Surg. 2016;

  9. Egan RJ, Monkhouse SJ, Meredith HE, et al. The reporting of gastric band slip and related complications; a review of the literature. Obes Surg. 2011;21(8):1280–8.

    Article  Google Scholar 

  10. Kirshtein B, Domchik S, Mizrahi S, et al. Laparoscopic diagnosis and treatment of postoperative complications. Am J Surg. 2009;197(1):19–23.

    Article  Google Scholar 

  11. Kirshtein B, Lantsberg L, Mizrahi S, et al. Bariatric emergencies for non-bariatric surgeons: complications of laparoscopic gastric banding. Obes Surg. 2010;20(11):1468–78.

    Article  Google Scholar 

  12. Kindel T, Martin E, Hungness E, et al. High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1070–5.

    Article  Google Scholar 

  13. Kowalewski PK, Olszewski R, Kwiatkowski A, et al. Life with a gastric band. Long-term outcomes of laparoscopic adjustable gastric banding-a retrospective study. Obes Surg. 2017;27(5):1250–3.

    Article  Google Scholar 

  14. Mann JP, Jakes AD, Hayden JD, et al. Systematic review of definitions of failure in revisional bariatric surgery. Obes Surg. 2015;25(3):571–4.

    Article  Google Scholar 

  15. Qiu J, Lundberg PW, Birriel TJ, et al. Revisional bariatric surgery for weight regain and refractory complications in a single MBSAQIP accredited center: what are we dealing with? Obes Surg. 2018;28(9):2789–95.

    Article  Google Scholar 

  16. Keren D, Romano-Zelekha O, Rainis T, et al. Revisional bariatric surgery in Israel: findings from the Israeli Bariatric Surgery Registry. Obes Surg. 2019;29(11):3514–22.

    Article  CAS  Google Scholar 

  17. Corcelles R, Barajas-Gamboa JS, Kroh M. Revisional bariatric surgery: are we opening a Pandora’s box? Cir Esp. 2019;97(9):477–9.

    Article  Google Scholar 

  18. Cohen R. Revisional bariatric surgery and choosing the first procedure: twenty-six years of follow-up in the SOS study. JAMA Surg. 2019;154(4):326–7.

    Article  Google Scholar 

  19. Mahawar KK, Nimeri A, Adamo M, et al. Practices Concerning Revisional Bariatric Surgery: a Survey of 460 Surgeons. Obes Surg. 2018;28(9):2650–60.

    Article  Google Scholar 

  20. Cheung D, Switzer NJ, Gill RS, et al. Revisional Bariatric Surgery following failed primary laparoscopic sleeve gastrectomy: a systematic review. Obes Surg. 2014;24(10):1757–63.

    Article  Google Scholar 

  21. AlSabah S, Al HE. The pedigree of baraitric surgery: a case series of revisional surgery post laparoscopic sleeve gastrectomy in 3 sisters. Int J Surg Case Rep. 2018;51:302–5.

    Article  Google Scholar 

  22. AlSabah S, Al Haddad E, Al-Subaie S, et al. Short-term results of revisional single-anastomosis gastric bypass after sleeve gastrectomy for weight regain. Obes Surg. 2018;28(8):2197–202.

    Article  Google Scholar 

  23. Gray KD, Moore MD, Elmously A, et al. Perioperative outcomes of laparoscopic and robotic revisional bariatric surgery in a complex patient population. Obes Surg. 2018;28(7):1852–9.

    Article  Google Scholar 

  24. Gagner M, Gumbs AA. Gastric banding: conversion to sleeve, bypass, or DS. Surg Endosc. 2007;21(11):1931–5.

    Article  Google Scholar 

  25. Spivak H, Beltran OR, Slavchev P, et al. Laparoscopic revision from LAP-BAND to gastric bypass. Surg Endosc. 2007;21(8):1388–92.

    Article  Google Scholar 

  26. Zadeh J, Le C, Ben-David K. Safety of adjustable gastric band conversion surgery: a systematic review and meta-analysis of the leak rate in 1- and 2-stage procedures. Surg Obes Relat Dis. 2020;16(3):437–44.

    Article  Google Scholar 

  27. Al-Kurd A, Grinbaum R, Abubeih A, et al. Results of conversion of gastric banding to gastric bypass in patients between 50 and 60 years of age are similar to those observed in younger patients. Am J Surg. 2019;217:745–9.

    Article  Google Scholar 

  28. International Surgical Outcomes Study g. Prospective observational cohort study on grading the severity of postoperative complications in global surgery research. Br J Surg. 2019;106(2):e73–80.

    Article  Google Scholar 

  29. Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.

    Article  Google Scholar 

  30. Garneau PY, Abouzahr O, Garofalo F, et al. Decreasing complication rates for one-stage conversion band to laparoscopic sleeve gastrectomy: a retrospective cohort study. J Minim Access Surg. 2019;

  31. Mognol P, Chosidow D, Marmuse JP. Laparoscopic conversion of laparoscopic gastric banding to Roux-en-Y gastric bypass: a review of 70 patients. Obes Surg. 2004;14(10):1349–53.

    Article  Google Scholar 

  32. 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.

    Article  CAS  Google Scholar 

  33. 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. 2018;28(6):1519–25.

    Article  Google Scholar 

  34. Al-Kurd A, Grinbaum R, Mizrahi I, Abubeih A, Indursky A, Abu Hamdan H, et al. A comparison between one- and two-stage revisional gastric bypass. Surg Endosc. 2018.

  35. Carandina S, Tabbara M, Bossi M, et al. Two stages conversion of failed laparoscopic adjustable gastric banding to laparoscopic roux-en-y gastric bypass. A study of one hundred patients. J Gastrointest Surg. 2014;18(10):1730–6.

    Article  Google Scholar 

  36. 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.

    Article  Google Scholar 

  37. Silecchia G, Rizzello M, De Angelis F, et al. Laparoscopic sleeve gastrectomy as a revisional procedure for failed laparoscopic gastric banding with a “2-step approach”: a multicenter study. Surg Obes Relat Dis. 2014;10(4):626–31.

    Article  Google Scholar 

  38. 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.

    Article  Google Scholar 

  39. Obeid NR, Schwack BF, Kurian MS, et al. Single-stage versus 2-stage sleeve gastrectomy as a conversion after failed adjustable gastric banding: 30-day outcomes. Surg Endosc. 2014;28(11):3186–92.

    Article  Google Scholar 

  40. 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(4):866–73.

    Article  Google Scholar 

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Author information

Author notes

  1. Zvi Perry and Orly Romano-Zelekha contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery A, Soroka University Medical Center, P.O Box 151, 64101, Beer-Sheva, Israel

    Zvi Perry, Itzhak Avital, Shahar Atias, Uri Netz & Boris Kirshtein

  2. Israel Center for Disease Control, Ministry of Health, Tel HaShomer, Israel

    Orly Romano-Zelekha

  3. Departments of Surgery A, Emek Medical Center, Afula, Israel

    Nasser Sakran

  4. Technion – Israel Institute of Technology, Haifa, Israel

    Nasser Sakran

Authors
  1. Zvi Perry
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  2. Orly Romano-Zelekha
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  3. Nasser Sakran
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  6. Uri Netz
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  7. Boris Kirshtein
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Correspondence to Zvi Perry.

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The study was approved by the regional ethics board. Due to the retrospective design and the anonymity of the data collected, patient informed consent was not required.

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The authors declare no competing interests.

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Perry, Z., Romano-Zelekha, O., Sakran, N. et al. Laparoscopic Sleeve Gastrectomy Following Failed Laparoscopic Adjustable Gastric Banding—a Comparison Between One- and two-Stage Procedures, an Israeli National Database Study. OBES SURG 31, 2364–2372 (2021). https://doi.org/10.1007/s11695-021-05312-1

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