Midterm results for gastric banding as salvage procedure for patients with weight loss failure after Roux-en- Y gastric bypass

Abstract

Background Studies reporting the revisionary options for weight loss failure after Roux-en- Y gastric bypass (RYGB) have been complex, underpowered, and lacking long-term data. We have previously shown that short-term (12-month) weight loss is achievable with laparoscopic adjustable gastric banding (LAGB) for failed RYGB. To report the midterm outcomes of LAGB after RYGB failure. Methods A retrospective review of prospectively collected data before and after RYGB, when available, and before and after LAGB was performed at the New York Langone University Hospital (New York, NY). The data collected included weight, height, body mass index (BMI), gender, race, age, operative time, length of stay, postoperative complications, and the percentage of excess weight loss. Results A total of 43 patients (9 men and 34 women) underwent LAGB after weight loss failure with RYGB. Of the 43 patients, 27 patients had undergone RYGB at other institutions, and preoperative RYGB data were available for 23 total patients. The average interval to LAGB was 6.6 years. The mean BMI before RYGB was 50.4 kg/m 2 and before LAGB was 43.3 kg/m 2 (%EWL was 17% after RYGB). At follow-up after LAGB, the average BMI was 35.2 kg/m 2, with a %EWL of 38% (calculated from LAGB only) at 26 months (range 6–66). At the 1- and 2-year follow-up visit, the BMI had decreased by 8.7 kg/m 2. The reoperation rate for complications related to LAGB was 10% and included 2 band erosions, 1 band slip, and 1 port flip. Conclusion The results of our study have shown that LAGB had good midterm data as a revisionary procedure for weight loss failure after RYGB.