One- versus two-stage conversions of adjustable gastric bands: an analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database |
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| Affiliation: | 1. Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio;2. Department of Surgery, Texas Tech University Health Sciences Center El Paso, El Paso, Texas;3. Department of Surgery, Mayo Clinic, Rochester, Minnesota;4. Department of Surgery, Whittington Hospital, London, United Kingdom;5. Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;1. Department of Population Science, American Cancer Society, Atlanta, Georgia;2. University of Southern California, Los Angeles, California;1. Department of Emergency Medicine, University of New Mexico School of Medicine, USA;2. Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Tokyo, Japan;3. School of Medicine, Nippon Medical School, Tokyo, Japan;4. Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan;5. College of Health Solutions, Arizona State University, Phoenix, AZ, USA;5. Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan;1. Department of Gastrointestinal Surgery, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, China;2. Department of Gastrointestinal Surgery, Graduate School of Dalian Medical University, Dalian, China;3. Department of Head and Neck Surgery, Graduate School of Dalian Medical University, Dalian, China |
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| Abstract: | BackgroundLaparoscopic adjustable gastric bands (AGB) are converted at high rates to secondary bariatric procedures. The available literature on the safety of converting in 1- versus 2-stage processes has not included large databases.ObjectiveTo evaluate the safety of a 1- versus 2-stage conversion of AGB.SettingMetabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), United States.MethodsThe MBSAQIP database for the years 2020 and 2021 was evaluated. One-stage AGB conversions were identified using Current Procedural Terminology codes and database variables. Multivariable analysis was performed to determine whether 1- or 2-stage conversions were associated with 30-day serious complications.ResultsThere were 12,085 patients who underwent conversion from previous AGB to sleeve gastrectomy (SG) (63.0%) or Roux-en-Y gastric bypass (RYGB) (37.0%), of whom 41.0% underwent conversion in 1 stage and 59.0% in 2 stages. Patients who underwent 2-stage conversions had higher body mass indexes. Rates of serious complications were higher for patients undergoing RYGB compared with SG (5.2% versus 3.3%, P < .001) but were similar between 1-stage and 2-stage conversions in both cohorts. In both cohorts, there were similar rates of anastomotic leaks, postoperative bleeding, reoperation, and readmissions. Mortality was rare and similar between conversion groups.ConclusionsThere was no difference in outcomes or complications in 30 days between 1- and 2-stage conversions of AGB to RYGB or SG. Conversions to RYGB have higher complication and mortality rates than to SG, but there was no statistically significant difference between staged procedures. One- and 2-stage conversions from AGB are equivalent in safety. |
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| Keywords: | Bariatric surgery Metabolic surgery: Adjustable gastric band Sleeve gastrectomy Roux-en-Y gastric bypass Revision Conversion 1 stage 2 stage |
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