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Obesity Surgery
Published in: Obesity Surgery 1/2017

01-01-2017 | Original Contributions

Conversion to Gastric Bypass After Either Failed Gastric Band or Failed Sleeve Gastrectomy

Authors: M. R. van Wezenbeek, T. R. van Oudheusden, J. P. J. G. M. de Zoete, J. F. Smulders, S. W. Nienhuijs

Published in: Obesity Surgery | Issue 1/2017

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Abstract

Background

Roux-en-Y gastric bypass (RYGB) is still considered the gold standard in bariatric surgery. Before, adjustable gastric banding (AGB) was regarded as an alternative; nowadays, sleeve gastrectomy (SG) is a more favorable alternative. In case of unsatisfactory results, RYGB is often performed as a secondary procedure. Conversion of an AGB is associated with a high risk of complications; the hypothesis was that this would be less after conversion of an SG.

Methods

All patients undergoing conversion to RYGB after AGB or SG between 2005 and 2012 were included for retrospective analysis. Patient characteristics, operative details, postoperative complications, the relief of complaints, weight loss, reasons for failure, and evolution of known comorbidities up to 2 years were analyzed.

Results

A total of 178 patients were included (79.8 % female): AGB 110 (61.8 %) versus SG 68 (38.2 %). Main reasons for conversion were weight regain/insufficient weight loss (48.4 %) or dysphagia/reflux complaints (39.9 %). Surgical complications were found in 19 patients (AGB 13 vs SG 6; p = 0.530). Infectious complications occurred in 13 patients (AGB 11 vs SG 2; p = 0.135). Total body weight loss was equal between groups after 2 years (AGB 31.6 ± 11.0 % vs SG 31.6 ± 12.0 %; p = 0.998). Similar results were found in a subgroup analysis on patients undergoing conversion for additional weight loss (AGB 31.7 ± 11.7 % vs SG 27.0 ± 13.1 %; p = 0.173).

Conclusions

Conversion to RYGB after failed AGB or SG showed comparable short-term results in terms of postoperative complications and weight loss.
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Metadata
Title
Conversion to Gastric Bypass After Either Failed Gastric Band or Failed Sleeve Gastrectomy
Authors
M. R. van Wezenbeek
T. R. van Oudheusden
J. P. J. G. M. de Zoete
J. F. Smulders
S. W. Nienhuijs
Publication date
01-01-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2249-2

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