Gastric band conversion to Roux-en-Y gastric bypass shows greater weight loss than conversion to sleeve gastrectomy: 5-year outcomes

Creange, Collin; Jenkins, Megan; Pergamo, Matthew; Fielding, George; Ren-Fielding, Christine; Schwack, Bradley

doi:10.1016/j.soard.2018.06.002

Cited by 27 publications

(7 citation statements)

References 31 publications

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“…Angrisani et al found no statistically significant difference in percent excess weight loss in patients converted to LSG or RYGB [ 15 ]. Other studies showed less weight loss with conversion to LSG when compared with RYGB [ 16 ] and less weight loss than primary LSG, as in our present experience.…”

Section: Discussionsupporting

confidence: 87%

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Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Angelis¹,

Boru²,

Iossa³

et al. 2021

Updates Surg

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Laparoscopic adjustable gastric band (LAGB) is the bariatric procedure most likely subject to revisional surgery. Both laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB) represent viable options, but the long-term results are still lacking. In 2014, we published the 2-year follow-up of our multicenter cohort of revisional LSG after failed LAGB. Evaluate the long-term follow-up (median 9.3 years) of the same cohort of patients. University and primary-care hospitals, Italy. We retrospectively examined a prospectively maintained database of the previously published multicenter cohort of 56 patients who underwent LSG after failed LAGB between 2008–2011. The control group included cross-matched non-revisional LSGs. The primary endpoint was weight loss, secondary endpoints co-morbidities, and the need for further bariatric surgery. The study group included 44 patients and the control group 56. We found %EWL 53% Vs. 67% (p = .021), %EBMIL (54 Vs. 68%, p = .018), %TWL (26 Vs. 34%, p = .002). We also found more severe GERD (gastroesophageal reflux disease) symptoms in the revisional than in the primary group (9.0 vs. 1.8% mild and 23.0 vs. 3.0% severe). Ten patients from the revisional group (22.7%) vs. eight in the primary group (13%) underwent further bariatric surgery (LRYGB). Our results showed less favorable weight loss in revisional than primary LSG after LABG, higher prevalence of GERD, and a more frequent need for further revisional surgery. Despite the study’s limitations, the present data suggest that the long-term outcomes may offset the possible reduced short-term complication rate after revisional sleeve gastrectomy for a failed LABG.

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Section: Discussionsupporting

confidence: 87%

“…Recent evidence supports that single-step and two steps approaches are both safe [ 16 , 17 ]. In both approaches, conversion to LSG might determine fewer short-term post-op complications than RYGB [ 4 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Angelis¹,

Boru²,

Iossa³

et al. 2021

Updates Surg

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“…The number of patients with heavily when selecting revisional procedures for high-risk patients. Although RNY has been associated with greater longterm weight loss [15,16], consideration must be given to the increased complication rate associated with conversion to RNY [5][6][7][8][9][10][11][12][13][14][15][16][17] when deciding to convert from AGB to either SG or RNY. Surgeons and patients, especially high-risk patients, should thoroughly discuss the potential pros and cons associated with each bariatric conversion procedure.…”

Section: Operative Technique For Conversionsmentioning

confidence: 99%

Single Stage Conversion from Laparoscopic Adjustable Gastric Band to Laparoscopic Sleeve Gastrectomy is Safer than Laparoscopic Adjustable Gastric Band to Roux-en-Y Gastric Bypass: Results of a 10-Year Analysis of Complications

S.¹,

Meredith²,

Petrone³

et al. 2020

Adv Laparoscopy

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Background: Conversion from laparoscopic Adjustable Gastric Band (AGB) to Roux-en-y gastric bypass (RNY) or Sleeve Gastrectomy (SG) is now common. Complication rates up to 25% have been reported. We reviewed the experience at a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Center of Excellence.Study Design: Our prospective database was retrospectively reviewed for single-stage conversions over a 10-year period ending in 2017 to assess outcomes compared to primary procedures. In revisions, we reinforce staple lines with buttress material, oversew staple lines in high-risk patients, and avoid stapling or anastomosing into scar capsule tissue. Statistical analysis was performed using t-test, chi-square, Fisher's Exact, McNemar's, and Wilcoxon signed rank tests.Results: † Fisher's Exact test for conversion RNY vs. conversion SG re-op p = 0.0039 Conclusions:The risk of leak appears to be higher with conversion to RNY vs. SG. This finding should be weighed heavily when selecting revision procedures for high-risk patients.

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“…El mini baipás gástrico (MGB, por sus siglas en inglés) es la tercera técnica en frecuencia y la de mayor crecimiento en los últimos años [4][5][6][7] . A pesar de la efectividad de estas cirugías, se pueden presentan complicaciones y reganancia de peso 8 .…”

Section: Introductionunclassified

Cirugía bariátrica secundaria en el Hospital Universitario San Ignacio

2021

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Introducción. La Organización Mundial de la Salud define la obesidad como un incremento en el porcentaje de grasa corporal, generalmente acompañado de aumento en el peso, cuya cantidad y distribución condicionan la salud del individuo. Se caracteriza por ser una enfermedad crónica y de muy difícil manejo. La cirugía bariátrica es un procedimiento cada vez más frecuente, que ha demostrado ser la mejor opción terapéutica para el manejo de la obesidad moderada y severa, enfermedad que ha ido ganado terreno en el mundo. Según la Encuesta Nacional de la Situación Nutricional en Colombia 2015, la incidencia de sobrepeso fue del 37,8 % y de obesidad del 18,7 %. Con el incremento de la cirugía bariátrica primaria, también se ha incrementado la frecuencia de la cirugía bariátrica de revisión, conversión y reversión, siendo la de conversión la más frecuente. Métodos. Estudio observacional retrospectivo en el que se analizaron los pacientes llevados a cirugía bariátrica de conversión en el Hospital Universitario San Ignacio entre 2014 y 2019. Resultados. En nuestra institución la cirugía de conversión corresponde al 8,8 %, y coincide con la estadística mundial para este procedimiento. La causa más frecuente, a diferencia de la literatura, es el reflujo gastroesofágico, seguido de la reganancia de peso. Discusión. Los resultados obtenidos en el Hospital Universitario San Ignacio se asemejan a las cifras mundiales de procedimientos de conversión. Se obtiene la resolución de los síntomas de reflujo gastroesofágico y el manejo adecuado de la reganancia de peso en un alto porcentaje de pacientes, con muy pocas complicaciones.

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Gastric band conversion to Roux-en-Y gastric bypass shows greater weight loss than conversion to sleeve gastrectomy: 5-year outcomes

Cited by 27 publications

References 31 publications

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Long-term outcomes of sleeve gastrectomy as a revisional procedure after failed gastric band: a multicenter cross-matched cohort study

Single Stage Conversion from Laparoscopic Adjustable Gastric Band to Laparoscopic Sleeve Gastrectomy is Safer than Laparoscopic Adjustable Gastric Band to Roux-en-Y Gastric Bypass: Results of a 10-Year Analysis of Complications

Cirugía bariátrica secundaria en el Hospital Universitario San Ignacio

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