4.5 Article

Adjustable Gastric Banding Conversion to One Anastomosis Gastric Bypass: Data Analysis of a Multicenter Database

Journal

JOURNAL OF GASTROINTESTINAL SURGERY
Volume 26, Issue 6, Pages 1147-1153

Publisher

SPRINGER
DOI: 10.1007/s11605-022-05277-1

Keywords

LAGB; Gastric banding; One anastomosis gastric bypass; OAGB; Revision; Revisional surgery; Conversion

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This study analyzed the complications, mortality, and medium-term weight loss results after converting LAGB to OAGB. The results showed that the conversion is safe and effective, with the one-stage approach being preferred for non-complicated cases.
Introduction One anastomosis gastric bypass (OAGB) has been proposed as a rescue technique for laparoscopic adjustable gastric banding (LAGB) poor responders. Aim We sought to analyze, complications, mortality, and medium-term weight loss results after LAGB conversion to OAGB. Methods Data analysis of an international multicenter database. Results One hundred eighty-nine LAGB-to-OAGB operations were retrospectively analyzed. Eighty-seven (46.0%) were converted in one stage. Patients operated on in two stages had a higher preoperative body mass index (BMI) (37.9 vs. 41.3 kg/m(2), p = 0.0007) and were more likely to have encountered technical complications, such as slippage or erosions (36% vs. 78%, p < 0.0001). Postoperative complications occurred in 4.8% of the patients (4.6% and 4.9% in the one-stage and the two-stage group, respectively). Leak rate, bleeding episodes, and mortality were 2.6%, 0.5%, and 0.5%, respectively. The final BMI was 30.2 at a mean follow-up of 31.4 months. Follow-up at 1, 3, and 5 years was 100%, 88%, and 70%, respectively. Conclusion Conversion from LAGB to OAGB is safe and effective. The one-stage approach appears to be the preferred option in non-complicate cases, while the two-step approach is mostly done for more complicated cases.

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