Does a prior conversion from adjustable gastric banding to sleeve gastrectomy impact the outcomes of subsequent conversion to Roux-en-Y gastric bypass?

Oct 14, 2025Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Does changing from an adjustable stomach band to a sleeve affect results when later switching to a Roux-en-Y gastric bypass?

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Abstract

Among 122 patients, those with a history of adjustable gastric banding (AGB) prior to sleeve gastrectomy (SG) and conversion to Roux-en-Y gastric bypass (RYGB) had lower weight loss percentages at 6, 12, and 24 months postoperatively.

The percentage of total weight loss (%TWL) at 6, 12, and 24 months was 15.4%, 17.9%, and 19.1% for patients without a history of AGB.
Patients with prior AGB experienced lower %TWL at the same intervals: 11.7%, 12.5%, and 13.3% respectively.
There were no significant differences in operative times or postoperative complications between the two groups.
Data were available for 72.2% of the total cohort at the 2-year follow-up.
The body mass index (BMI) prior to RYGB revision was 36.6 kg/m² for patients with AGB history and 35.8 kg/m² for those without.

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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.

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Does a prior conversion from adjustable gastric banding to sleeve gastrectomy impact the outcomes of subsequent conversion to Roux-en-Y gastric bypass?

Abstract

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