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Obesity Surgery
Published in: Obesity Surgery 5/2016

01-05-2016 | Original Contributions

Laparoscopic Adjustable Gastric Banding Revisions in Singapore: a 10-Year Experience

Authors: Kee Yuan Ngiam, Valerie Yu Hui Khoo, Lucy Kong, Anton Kui Sing Cheng

Published in: Obesity Surgery | Issue 5/2016

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Abstract

Background

Bariatric surgery is increasingly being carried out and revisional procedures have also risen in concert. A review of the complications and revisions might elucidate technical and patient factors that influence the outcomes of bariatric surgeries in Asian patients. The objective of this study is to review the safety and efficacy of revisional bariatric surgery in a single center in Singapore over a 10-year period.

Methods

The setting of this study is a single public hospital with a multidisciplinary bariatric service including a weight management center, specialized endocrinology services, and bariatric surgical team. Participants were selected for surgery based on body mass index (BMI) and comorbidities. All patients underwent primary laparoscopic adjustable gastric banding (LAGB). Patients were then analyzed according to the types of revisional surgeries. The primary outcome was the type of complications and revisional surgeries. Secondary outcomes include short-term excess weight loss and further complications.

Results

A total of 365 patients were analyzed. 9.6 % had a secondary procedure. In particular, two groups of complications required revisional surgery: failure of sustained weight loss and complications related to the LAGB insertion and use. Revisional surgeries had equivalent major complication rates (5.7 %) compared to primary bariatric surgeries (6.8 %). Revisional surgeries such as revisional LAGB (4.9 ± 9.8 kg), laparoscopic sleeve gastrectomy (LSG; 6.9 ± 21.0 kg), Roux-en-Y gastric bypass (RYGB; 4.6 ± 13.0 kg), and bilio-pancreatic diversion (BPD; 3.5 ± 6.3 kg) had modest weight loss compared to primary weight loss (12.7 ± 9.5 kg). Primary LAGB had a greater percentage excess weight loss in the first and second years post-surgery compared to revisional surgeries. There was one mortality post-primary surgery and no post-revisional surgical mortalities.

Conclusions

Revisional bariatric surgery for complications related to the primary surgery is safe but had reduced excess weight loss compared to the initial surgery.
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Metadata
Title
Laparoscopic Adjustable Gastric Banding Revisions in Singapore: a 10-Year Experience
Authors
Kee Yuan Ngiam
Valerie Yu Hui Khoo
Lucy Kong
Anton Kui Sing Cheng
Publication date
01-05-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1852-y

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