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Obesity Surgery
Published in: Obesity Surgery 7/2012

01-07-2012 | Clinical Research

Laparoscopic Conversion of Failed Gastric Banding to Roux-en-Y Gastric Bypass. Short-term Follow-up and Technical Considerations

Authors: M. W. Hii, A. C. Lake, C. Kenfield, G. H. Hopkins

Published in: Obesity Surgery | Issue 7/2012

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Abstract

Background

The most common bariatric procedure in Australia is laparoscopic adjustable gastric banding (LAGB). Although successful, there is a substantial long-term complication and failure rate. Band removal and conversion to Roux-en-Y gastric bypass (RYGB) can be an effective treatment for complicated or failed bands. There is increasing evidence supporting good weight loss and resolution of band-related complications after conversion.

Methods

A prospective database of all bariatric procedures is maintained. Patients having revision of LAGB to RYGB between December 2007 and April 2011 were included in this study. Indications for surgery, operative details, morbidity and mortality, weight loss data, and post-operative symptoms were recorded.

Results

Eighty-two patients were included. Indications for surgery were inadequate weight loss (n = 42), adverse symptoms (reflux = 8, dysphagia = 2), and band complications (band erosion = 7, band sepsis = 1, band slip = 11, esophageal dilatation = 11). Seventy-eight percent of procedures were completed in a single stage and 96.3% laparoscopically. There was no 30-day mortality. Total morbidity was 46.3% (minor complications = 32.9%, major complications = 13.4%). Median BMI was 43 kg/m2 pre-RYGB and 34 kg/m2 after 12 months. All patients with adverse band-related symptoms had resolution.

Conclusions

LAGB has a considerable complication and failure rate. Conversion of these patients to RYGB results in further weight loss and resolution of adverse symptoms. This is a challenging procedure, but can usually be performed in a single stage with acceptable morbidity and mortality. These patients should be treated in high-volume, subspecialty bariatric units.
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Metadata
Title
Laparoscopic Conversion of Failed Gastric Banding to Roux-en-Y Gastric Bypass. Short-term Follow-up and Technical Considerations
Authors
M. W. Hii
A. C. Lake
C. Kenfield
G. H. Hopkins
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 7/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0594-3

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