A 12-Month Review of Revisional Single Anastomosis Gastric Bypass for Complicated Laparoscopic Adjustable Gastric Banding for Body Mass Index over 35

Aug 31, 2017Obesity surgery

One-Year Outcomes of Revising Adjustable Stomach Bands to Single-Connection Gastric Bypass in People with BMI Over 35

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Abstract

The mean body mass index (BMI) decreased from 41.6 kg/m² at 6 weeks to 33.2 kg/m² at 12 months after conversion from laparoscopic adjustable gastric banding to single anastomosis gastric bypass.

Average percentage excess weight loss (EWL) increased from 21.0% at 6 weeks to 67.0% at 12 months.
Postoperative follow-up rates were 97% at 6 weeks, decreasing to 46% at 12 months.
Early morbidity within 30 days post-surgery was observed in 20.3% of patients.
Major complications classified as grade 3a or higher occurred in 13.5% of patients.

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BACKGROUND: In many countries, laparoscopic adjustable gastric banding (LAGB) was previously the most commonly performed bariatric procedure due to its operative safety and early efficacy. This procedure is now superseded because of doubtful long-term results and late complications. Many people eventually required revisional bariatric surgery such as conversion to single anastomosis gastric bypass (SAGB). This study aims to assess the safety and durability of single-stage conversion from LAGB to SAGB in patients who are intolerant to LAGB and who also fail to lose weight, or re-gain weight.

METHODS: Seventy-four patients with BMI > 35 kg mwere selected from a prospective bariatric database between July 2012 and December 2015 for revisional laparoscopic SAGB surgery and were followed up at 6 weeks, 3, 6 and 12 months after their operation. -2

RESULTS: The mean BMI at 6 weeks, then 3, 6 and 12 months were 41.6 ± 7.66, 38.8 ± 7.54, 35.4 ± 7.10 and 33.2 ± 7.34 kg m, respectively. The mean percentage EWL at 6 weeks then 3, 6 and 12 months were 21.0 ± 9.12, 37.8 ± 12.5, 55.1 ± 15.8 and 67.0 ± 19.6%, respectively. Postoperative follow-up at these times were 97, 85, 69 and 46%, respectively. Early (< 30 day) morbidity was 20.3% with major complications of CD grade 3a or more of 13.5%. -2

CONCLUSIONS: This study demonstrates that single-stage revisional SAGB after a failed LAGB achieved good short-term weight loss and low 30-day morbidity.

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A 12-Month Review of Revisional Single Anastomosis Gastric Bypass for Complicated Laparoscopic Adjustable Gastric Banding for Body Mass Index over 35

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