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

Abstract

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 This procedure is now superseded because of doubtful long-term results and late complications.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. Seventy-four patients with BMI >35kgm-2 were selected from a prospective bariatric database between July 2012 and December 2015 for revisional laparoscopic SAGB surgery and were followed up at 6weeks, 3, 6 and 12months after their operation. The mean BMI at 6weeks, then 3, 6 and 12months were 41.6±7.66, 38.8±7.54, 35.4±7.10 and 33.2±7.34kgm-2, respectively. The mean percentage EWL at 6weeks then 3, 6 and 12months 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 (<30day) morbidity was 20.3% with major complications of CD grade 3a or more of 13.5%. This study demonstrates that single-stage revisional SAGB after a failed LAGB achieved good short-term weight loss and low 30-day morbidity.