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Revisional surgery after failed adjustable gastric banding: institutional experience with 90 consecutive cases

Authors :
Michele Diana
Jacques Marescaux
Hurng-Sheng Wu
Keng-Hao Liu
Michel Vix
Didier Mutter
Source :
Surgical endoscopy. 27(11)
Publication Year :
2013

Abstract

Revisional surgery may be required in a high percentage of patients (up to 30 %) after laparoscopic adjustable gastric banding (LAGB). We report our institutional experience with revisional surgery.From January 1996 to November 2011, 90 patients underwent revisional surgery after failed LAGB. Both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) were proposed. In the presence of gastroesophageal reflux disease, esophageal dysmotility, hiatal hernia, or diabetes, RYGB was preferentially proposed.In two cases, revisional surgery was aborted due to local severe adhesions. Eighty-eight patients (74 females; mean age 42.79 ± 10.03 years; mean BMI 44.73 ± 6.19 kg/m(2)) successfully underwent revisional SG (n = 48) or RYGB (n = 40). One-stage surgery was performed in 29 cases. Follow-up rate was 78.2 % (n = 61) and 40.9 % (n = 36) at 12 and 24 months respectively. One major complication after SG (staple-line leakage) was observed. Overall postoperative excess weight loss (%EWL) was 31.24, 40.92, 52.41, and 51.68 % at 3, 6, 12, and 24 months of follow-up respectively. There was a statistically significant higher %EWL at 1 year in patients50 years old (55.9 vs. 41.5 % in patients50 years old; p = 0.01), of female gender (55.22 vs. 40.73 % in male; p = 0.04), and in patients in which the AGB was in place for5 years (57.09 vs. 47.43 % if5 years p = 0.02).Revisional surgery is safe and effective. Patients50 years, of female gender, and with the AGB in place for5 years had better %EWL after revisional surgery.

Details

ISSN :
14322218
Volume :
27
Issue :
11
Database :
OpenAIRE
Journal :
Surgical endoscopy
Accession number :
edsair.doi.dedup.....aed0df1517ac35a5b07f94c52ba81bb4