Revision of Failed Laparoscopic Adjustable Gastric Banding to Roux-en-Y Gastric Bypass |
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Authors: | B van Wageningen MD F J Berends MD PhD B Van Ramshorst MD Phd I F M Janssen MD |
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Institution: | (1) Department of Surgery, Rijnstate Hospital, The Netherlands;(2) Department of Surgery, Rijnstate Hospital, The Netherlands;(3) Department of Surgery, St. Antonius Hospital, The Netherlands;(4) Department of Surgery, Rijnstate Hospital, The Netherlands |
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Abstract: | Background: The most common bariatric surgical operation in Europe, laparoscopic adjustable gastric banding (LAGB), is reported
to have a high incidence of long-term complications. Also, insufficient weight loss is reported. We investigated whether revision
to Roux-en-Y gastric bypass (RYGBP) is a safe and effective therapy for failed LAGB and for further weight loss. Methods:
From Jan 1999 to May 2004, 613 patients underwent LAGB. Of these, 47 underwent later revisional Roux-en-Y gastric bypass (RYGBP).
Using a prospectively collected database, we analyzed these revisions. All procedures were done by two surgeons with extensive
experience in bariatric surgery. Results: All patients were treated with laparoscopic (n=26) or open (n=21) RYGBP after failed
LAGB. Total follow-up after LAGB was 5.5±2.0 years. For the RYGBP, mean operating time was 161±53 minutes, estimated blood
loss was 219±329 ml, and hospital stay was 6.7±4.5 days. There has been no mortality. Early complications occurred in 17%.
There was only one late complication (2%) – a ventral hernia. The mean BMI prior to any form of bariatric surgery was 49.2±9.3
kg/m2, and decreased to 45.8±8.9 kg/m2 after LAGB and was again reduced to 37.7±8.7 kg/m2 after RYGBP within our follow-up period. Conclusion: Conversion of LAGB to RYGBP is effective to treat complications of LAGB
and to further reduce the weight to healthier levels in morbidly obese patients. |
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Keywords: | MORBID OBESITY BARIATRIC SURGERY LAPAROSCOPIC GASTRIC BANDING GASTRIC BYPASS REVISIONAL SURGERY |
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