Single-center experience in single-stage conversions of gastric banding to sleeve gastrectomy: is it as safe as 2-stage conversions?

Abstract

BackgroundLaparoscopic sleeve gastrectomy (LSG) can be performed after obesity persistence following laparoscopic adjustable gastric banding (LAGB) with a positive safety profile. However, some argue that the conversion should be performed in 2 stages rather than 1 because of perioperative complications. The aim of this study is to determine the safety profile of single-stage LAGB to LSG conversion. SettingAcademic hospital, United States. Material and methodsFrom October 2009 to July 2016, a total of 76 patients underwent conversions to a LSG because of obesity persistence after LAGB. Of these cases, 65 were done as single-stage procedures and 11 were done in 2 stages. Perioperative complications were compared between the 1-stage and 2-stage conversion groups. ResultsMean operative time was 122.5±26.1 minutes (range, 75-186) in the single-stage group and 103.6±29.7 minutes (range, 66–145) in the 2-stage group (P>0.08). Mean length of hospital stay was 1.5±.6 days (range, 1–3) in the single-stage group and 1.6±.7 days (range, 1–3) in the 2-stage group (sleeve gastrectomy portion) (P> .58).Two patients (3.1%) in the single-stage group required readmission within 60 days after the conversion because of dehydration (n = 1) and abdominal wall cellulitis (n = 1). Both patients were treated conservatively, and no patient in the 2-stage group required readmission within 60 days from LSG. No patient required reoperation within 60 days, and no patient developed a staple line leakage during the period of follow-up. ConclusionSingle-stage laparoscopic conversion of LAGB to LSG is feasible and, in appropriately selected patients, does not seem to increase the risk of complications compared with 2-stage procedures.