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Obesity Surgery
Published in: Obesity Surgery 11/2018

01-11-2018 | Original Contributions

Destiny of Failed Adjustable Gastric Bandings: Do All the Patients Need Further Bariatric Surgery?

Authors: Alessandro Genzone, Alice Ferguglia, Marijus Ambrazevicius, Mauro Toppino, Luca Grasso, Marco Ettore Allaix, Mario Morino

Published in: Obesity Surgery | Issue 11/2018

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Abstract

Purpose

The number of laparoscopic adjustable gastric banding (LAGB) removal has increased throughout the years. The aim of the study was to evaluate the outcomes in patients undergoing LAGB removal with or without further bariatric surgery.

Materials and Methods

Data prospectively collected from consecutive patients undergoing LAGB removal from 2008 to 2016 at our institution were retrospectively analyzed. Obesity-related comorbidities, complications, and body mass index (BMI) before removal and at 1-year follow-up were evaluated.

Results

A total of 156 patients were included in the study. Seventy-six patients had further surgery (SURG group): 55 underwent laparoscopic sleeve gastrectomy (LSG) and 21 laparoscopic Roux-en-Y gastric bypass (LRYGB). Eighty patients underwent only LAGB removal (No-SURG group). The mean BMI was lower in the No-SURG group (33.9 vs 36.3 kg/m2, p = 0.0055). Reasons for removal were different in the two groups: dysphagia, frequent vomiting, and LAGB-related complications requiring urgent treatment occurred more commonly in the No-SURG group (p < 0.05): 71.3 vs 51.3%, 67.5% vs. 38.2%, 28.8% vs. 6.6%, respectively. At 1-year follow-up, 96.3% of No-SURG patients regained weight after LAGB removal; two (2.5%) patients showed new-onset comorbidities, four (5%) needed adjustments in pharmacological therapy, and four (5%) complained from persistence of GERD symptoms. Additional surgery provided significant weight loss: the mean %TWL was 23.7% after LSGs and 27.2% after LRYGBs.

Conclusions

LAGB is associated with a high rate of reoperation. Further bariatric surgery after LAGB removal should be considered due to weight regain, persistence of GERD symptoms, and new-onset comorbidities.
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Metadata
Title
Destiny of Failed Adjustable Gastric Bandings: Do All the Patients Need Further Bariatric Surgery?
Authors
Alessandro Genzone
Alice Ferguglia
Marijus Ambrazevicius
Mauro Toppino
Luca Grasso
Marco Ettore Allaix
Mario Morino
Publication date
01-11-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 11/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3373-y

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