BACKGROUND: Adjustable gastric banding (AGB) was a widely performed bariatric surgery, but over time, sleeve gastrectomy (SG) became the most commonly performed procedure. Both AGB and SG carry the risk of weight regain, which may require conversion to Roux-en-Y gastric bypass (RYGB). However, the impact of AGB prior to SG on postoperative outcomes after conversion to RYGB remains unclear.
OBJECTIVES: The aim of this study is to compare the postoperative outcomes, including weight loss, between patients who underwent 3 bariatric procedures, including AGB, SG and finally conversion to RYGB and those who only underwent SG and conversion to RYGB.
SETTING: University Hospital.
METHODS: A retrospective analysis of patients who underwent SG conversion to RYGB between 2016 and 2024 was conducted. Demographics, perioperative outcomes, and weight loss were compared between patients with prior history of AGB and those without.
RESULTS: A total of 122 patients were included, of whom 25 had AGB prior to SG conversion to RYGB. The body mass index (BMI) prior to the revision was 36.6 and 35.8kg/m, respectively. At the 2-year follow-up, data were available for 72.2% of the total cohort. There was no significant difference in operative times (P = .77) and early and late postoperative complications (P > .05). However, patients without a history of AGB demonstrated significantly greater weight loss at 6, 12, and 24 months postoperatively. Their percentage of total weight loss (%TWL) was 15.4%, 17.9%, and 19.1%, respectively, compared to 11.7%, 12.5%, and 13.3% in patients who had undergone AGB prior to SG conversion to RYGB (P = .012). 2
CONCLUSIONS: Patients who underwent AGB prior to other bariatric procedures tend to experience poorer weight loss compared to those who did not have prior band.
