Third time’s a charm: band to sleeve to bypass

Nov 17, 2023Surgical endoscopy

Comparing three weight-loss surgeries: band, sleeve, and bypass

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

A total of 276 patients underwent conversion from adjustable gastric bands to sleeve gastrectomy and then to Roux-en-Y gastric bypass.

The most common reason for conversion from sleeve gastrectomy to Roux-en-Y gastric bypass was gastroesophageal reflux disease (GERD), affecting 55.1% of patients.
Inadequate weight loss or weight regain was the second most frequent reason for conversion, seen in 36.9% of cases.
Patients converting for inadequate weight loss or weight regain had a higher baseline body mass index and prevalence of sleep apnea.
The group with reasons classified as 'other' had a higher incidence of open surgical approaches and concurrent lysis of adhesions.
Higher rates of anastomotic leaks, reoperations, serious complications, and mortality were associated with the 'other reasons' group.

AI simplified

BACKGROUND: Adjustable gastric bands (AGB) are frequently converted to sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) due to weight recurrence or band complications. Such conversions carry a higher-risk than primary procedures. Some patients undergo two conversions-from AGB to SG, and subsequently from SG to RYGB. This presents a unique situation with limited literature on indications and complication rates associated with these double conversions.

METHODS: We examined the 2020-2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use File to evaluate conversions from AGB to SG and then to RYGB. Patient and operative characteristics, along with outcomes, were evaluated. Descriptive statistics were applied.

RESULTS: We identified 276 patients who underwent a conversion from AGB to SG and then to RYGB. The primary reason for the second conversion (SG to RYGB) was gastroesophageal reflux disease (GERD) at 55.1%, followed by inadequate weight loss or weight regain (IWL/WR) at 36.9%. The remaining reasons included dysphagia, nausea, vomiting, or others. Patients converted for IWL/WR demonstrated a higher baseline body mass index and prevalence of sleep apnea compared to other cohorts (both p < 0.001). Meanwhile, patients in the "other reasons" group had the highest rate of open surgical approaches (9.1%) and concurrent lysis of adhesions (p = 0.001 and p = 0.022), with correspondingly higher rates of anastomotic leak, reoperations, serious complications, and mortality.

CONCLUSIONS: Patients undergoing double conversions (AGB to SG to RYGB) do so primarily for GERD or IWL/WR. Further research is required to better define the optimal primary operation for each patient, aiming to reduce the necessity for multiple conversions.

Full Text

Full text is available at the source.

View full text (PDF) ↗View full text (HTML) ↗

Third time’s a charm: band to sleeve to bypass

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief