Single-stage conversions from failed gastric band to sleeve gastrectomy versus Roux-en-Y gastric bypass: results from the United Kingdom National Bariatric Surgical Registry

Aug 6, 2018Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Outcomes of one-step surgery changing failed stomach band to sleeve gastrectomy or gastric bypass in the UK

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Abstract

In a comparison of 141 patients, conversion from gastric band to Roux-en-Y gastric bypass was associated with a higher readmission or reintervention rate of 16 compared to 0 for sleeve gastrectomy (P = .04).

Both Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy resulted in similar percentage excess weight loss at 1 year, with 52.1% for sleeve and 57.1% for bypass (P = .4).
The study indicates that conversion to sleeve gastrectomy may have a better safety profile during the perioperative period.
Data were collected from the National Bariatric Surgery Registry, covering procedures from 2009 to 2014.

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BACKGROUND: For patients in whom laparoscopic adjustable gastric band has failed, conversion to Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy are both options for further surgical treatment. There are limited data comparing these 2 procedures. The National Bariatric Surgery Registry is a comprehensive United Kingdom-wide database of bariatric procedures, in which preoperative demographic characteristics and clinical outcomes are prospectively recorded.

OBJECTIVES: To compare perioperative complication rate and short-term outcomes of patients undergoing single-stage conversion of gastric band to Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy.

SETTING: United Kingdom national bariatric surgery database.

METHODS: From the National Bariatric Surgical Registry data set, we identified 141 patients undergoing single-stage conversion from gastric band to either gastric bypass (113) or sleeve gastrectomy (28) between 2009 and 2014, and analyzed their clinical outcomes.

RESULTS: With respect to perioperative outcomes gastric bypass was associated with a higher incidence of readmission or reintervention postoperatively (16 versus 0; P = .04). There was no difference in percentage excess weight loss between sleeve gastrectomy and gastric bypass at final follow-up at 1 year (52.1% versus 57.1% respectively; P = .4).

CONCLUSIONS: Conversion from band to sleeve or bypass give comparable good early excess weight loss; however, conversion to sleeve is associated with a better perioperative safety profile.

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Single-stage conversions from failed gastric band to sleeve gastrectomy versus Roux-en-Y gastric bypass: results from the United Kingdom National Bariatric Surgical Registry

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