The durability of revisional sleeve gastrectomy and Roux-en-Y gastric bypass after previous adjustable gastric band

Oct 11, 2022Surgical endoscopy

Long-term results of sleeve gastrectomy and gastric bypass after a failed adjustable stomach band

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

The estimated 5-year cumulative revision or conversion incidence rate after prior adjustable gastric banding to sleeve gastrectomy was 14.4% for one-stage and 11.6% for two-stage procedures.

The cumulative RC incidence rate for primary sleeve gastrectomy was 5.2%, while primary Roux-en-Y gastric bypass had a rate of 1.1%.
One-stage and two-stage conversions from adjustable gastric banding to sleeve gastrectomy showed higher RC rates compared to primary surgeries.
The relative risk of RC did not significantly differ between Roux-en-Y gastric bypass and sleeve gastrectomy after adjustable gastric banding conversion.
Converting from adjustable gastric banding to sleeve gastrectomy is associated with a higher frequency of revision compared to primary surgeries.

AI simplified

BACKGROUND: Patients with adjustable gastric banding (AGB) often require revision to one-stage or two-stage sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).

OBJECTIVE: To compare the long-term durability of revisional SG and RYGB, in terms of subsequent revision or conversion (RC).

METHODS: The New York Statewide Planning and Research Cooperative Systems dataset was queried from 2006 to 2013 for patients who underwent primary SG and RYGB, one-stage, and two-stage conversion from AGB to SG and RYGB. Patients who required RC were identified. A multivariable Cox proportional hazard model was used to compare the RC risk among these groups.

RESULTS: 13,749 had primary SG, 621 one-stage, and 321 two-stage AGB to SG. 31,814 had primary RYGB, 555 one-stage, and 248 two-stage AGB to RYGB. The estimated 5-year cumulative RC incidence rate was significantly lower after primary surgery than after prior AGB (one-stage AGB to SG 14.4%, two-stage AGB to SG 11.6%, primary SG 5.2%, one-stage AGB to RYBG 3.4%, two-stage AGB to RYGB 2.9%, and primary RYGB 1.1%, p-value < 0.0001). RYGB and SG did not differ significantly in terms of the elevation effect of one- and two-stage AGB conversion over primary surgeries (RYGB vs SG: one stage vs primary ratio of HR = 0.97, 95% CI = [0.58, 1.63], p-value = 0.9153; two stage vs primary ratio of HR = 1. 02, 95% CI = [0.50, 2.07], p-value = 0.9596).

CONCLUSION: RC after AGB to SG or RYGB is more frequent compared to primary surgeries with procedures following AGB to SG being more common than AGB to RYGB. However, that difference was proportionally similar to the RC rate ratio differences noted for primary SG and RYGB.

Full Text

Full text is available at the source.

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

The durability of revisional sleeve gastrectomy and Roux-en-Y gastric bypass after previous adjustable gastric band

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