One-stage conversion of laparoscopic adjustable gastric banding to laparoscopic 1-anastomosis gastric bypass: a single-center experience on 1,000 patients at 5 years of follow-up

Background: Data regarding the use of 1-anastomosis gastric bypass (OAGB) as a conversion technique after laparoscopic adjustable gastric banding (LAGB) failure is scarce in the literature. Objectives: The aim of this study was to assess our experience with OAGB as a rescue procedure after failed LAGB. Setting: This study involved patients treated at a private hospital in France. Methods: This single-center retrospective study included all consecutive patients receiving OAGB from January 2005 to January 2016. Of the 3,224 patients, 63.5% received primary OAGB (pOAGB) and 36.5% received OAGB as a conversion procedure after LAGB (cOAGB). Results: During the period considered, 2,046 patients with obesity received pOAGB, whereas 1,000 patients underwent conversion of LAGB to OAGB in 1 step. The rate of patients lost to follow-up at 5 years was 31% in the pOAGB group and 32.5% in the cOAGB group (P = .4). Five years after the surgery, the mean body mass index was 30.8 +/- 10.2 kg/m(2), the mean percentage total weight loss was 34.6% +/- 9.6%, and the mean percentage excess weight loss was 76.1% +/- 24.6% in the pOAGB group, and the mean was 29.7 +/- 10.4 kg/m(2) (P = .58), the mean percentage total weight loss was 33.8% +/- 10.2% (P = .82) and the mean percentage excess weight loss was 73.5% +/- 22.2% (P = .78) in the cOAGB group. There was no difference in terms of early complications between the 2 groups (3.2% pOAGB versus 3.6% cOAGB, P = .59), while there was a statistically significant difference in terms of late complications (11% pOAGB versus 18% cOAGB, P < .00001). In particular, there was a significantly higher incidence of symptomatic postoperative biliary reflux in the cOAGB group (12% in cOAGB versus 5% in pOAGB, P < .00001). Conclusion: In this study, OAGB was effective and safe as a rescue technique after LAGB failure. Conversion in one step did not appear to increase the risk of early complications, whereas a history of gastric banding seems to increase the risk of bile reflux in the long term. (C) 2022 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Automated summary

This study aimed to evaluate the effectiveness of OAGB as a rescue procedure after LAGB failure. The results showed that OAGB as a conversion surgery had certain safety and efficacy, but a history of gastric banding was associated with an increased risk of long-term bile reflux.