Abstract
PurposeLaparoscopic adjustable gastric banding (LAGB) was a common procedure worldwide but associated with a high rate of long-term failure. This study aims to evaluate the safety and effectiveness of conversion to one anastomosis gastric bypass (OAGB) after failed LAGB.Materials and MethodsWe undertook a retrospective analysis of a prospectively maintained database in a tertiary referral center for bariatric surgery. All cases of revisional OAGB with a biliopancreatic limb (BPL) of 150 cm after failed LAGB performed between 2010 and 2016 were analyzed.ResultsOverall, 215 patients underwent conversion from LAGB to OAGB. Indication for surgery was primary weight loss (WL) failure in 30.7% of cases and long-term complications in the remaining patients, with or without associated weight regain. At the time of OAGB, the mean age was 43.2 ± 10.5 years and the mean BMI was 42 ± 6.9. Overall postoperative morbidity was 13.5%. The postoperative abscess ± leak rate was 5.9% in the overall population. Two years after OAGB, 9.7% of patients were lost to follow-up, % excess weight loss (EWL) was 88.2 ± 23.9, and % total weight loss (TWL) was 38.7 ± 9.3. At 5 years, 16.6% of patients were lost to follow-up, %EWL was 82.4 ± 25, and %TWL was 36.1 ± 10. There was no statistical difference in complication rates or WL results between the one-stage and two-stage approaches.ConclusionOAGB with a 150-cm BPL represents a safe and effective option after failed LAGB. Both synchronous OAGB and two-step revisional OAGB guarantee satisfying results in terms of postoperative morbidity and WL outcomes.Graphical abstract (PLEASE CORRECT THE GRAPHICAL ABSTRACT !!! 215 PATIENTS INSTEAD OF 250
Highlights
Obesity still represents a global health concern
Laparoscopic adjustable gastric banding (LAGB) has been widely practiced in France since 1995, with more than 160,000 procedures performed to date [6]
Residual %total weight loss (TWL) and %excess weight loss (EWL) were defined as the weight loss (WL) obtained with the primary treatment (LAGB) at the time of secondary treatment (OAGB)
Summary
Obesity still represents a global health concern. Bariatric surgery is the most effective therapy for morbid obesity, resulting in sustainable weight loss (WL) and an improvement in obesity-related comorbidities [1, 2]. Laparoscopic adjustable gastric banding (LAGB) was the first minimally invasive bariatric procedure to be widely adopted [3]. In the early 2000s in France, LAGB was the technique of choice in 80% of patients undergoing bariatric surgery [3,4,5]. LAGB has been widely practiced in France since 1995, with more than 160,000 procedures performed to date [6]. The number of LAGB procedures represented 24.4% of the total bariatric procedures in 2003, it
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