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Year: 2012 Volume: 8 Issue: 3

Year: 2012 Volume: 8 Issue: 2

Year: 2012 Volume: 8 Issue: 1

Conversion of failed gastric banding into four different bariatric procedures.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Abu-Gazala, Samir Keidar, Andrei
Description	Country affiliation: Israel Author Affiliation: Abu-Gazala S ( Department of Surgery, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.)
Abstract	BACKGROUND: The most common bariatric operation in Europe, laparoscopic adjustable gastric banding (LAGB), is reported to have a high incidence of long-term complications. Also, insufficient weight loss is reported. The optimal conversion technique is unknown. Our objective was to report our experience in the conversions of failed laparoscopic gastric banding procedures to 4 different bariatric procedures at a university hospital. METHODS: From March 2006 to December 2010, 630 bariatric operations were performed. Of these patients, 45 underwent conversion of failed LAGB (n = 38) and nonadjustable gastric banding (n = 7). Using a prospectively collected database, we analyzed these procedures. RESULTS: The 45 patients underwent laparoscopic conversion of failed LAGB (n = 38) and nonadjustable gastric banding (n = 7) to 4 different procedures. Of the 45 patients, 18 underwent conversion to laparoscopic sleeve gastrectomy, 18 to laparoscopic Roux-en-Y gastric bypass, 7 to laparoscopic biliopancreatic diversion with duodenal switch, and 2 to laparoscopic biliopancreatic diversion. All conversions but 1 were completed laparoscopically. The mean operating time and hospital stay for laparoscopic sleeve gastrectomy, laparoscopic Roux-en-Y gastric bypass, laparoscopic biliopancreatic diversion with duodenal switch, and biliopancreatic diversion was 111 ± 28 minutes and 4.3 ± 1.4 days, 195 ± 59 minutes and 3.9 ± 1.5 days, 248 ± 113 minutes, and 5.9 ± 2.6 days, and 203 minutes and 6.5 days, respectively. No patient died. Perioperative complications occurred in 4 patients (9.8%). The mean body mass index decreased from 41.5 ± 8 kg/m(2) to 31.3 ± 6.8 kg/m(2) during a mean follow-up period of 13.7 ± 9.6 months. Although laparoscopic biliopancreatic diversion with and without duodenal switch had the greatest preoperative body mass index, they achieved the greatest excess weight loss. CONCLUSION: Conversion of LAGB or nonadjustable gastric banding to laparoscopic sleeve gastrectomy, laparoscopic Roux-en-Y gastric bypass, and laparoscopic biliopancreatic diversion with or without duodenal switch is feasible and effective to treat the complications of LAGB and to further reduce the weight of morbidly obese patients.
File Format	HTM / HTML
ISSN	15507289
Issue Number	4
Volume Number	8
e-ISSN	18787533
Journal	Surgery for Obesity and Related Diseases
Language	English
Publisher	Elsevier
Publisher Date	2012-07-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Metabolism Discipline General Surgery Bariatric Surgery Methods Biliopancreatic Diversion Obesity, Morbid Surgery Adult Body Mass Index Duodenum Female Gastric Bypass Gastroplasty Humans Intraoperative Complications Etiology Male Middle Aged Operative Time Postoperative Complications Prospective Studies Reoperation Treatment Outcome Weight Loss Physiology Journal Article
Content Type	Text
Resource Type	Article
Subject	Surgery

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Revision and reversal after biliopancreatic diversion for excessive side effects or ineffective weight loss: a review of the current literature on indications and procedures.

Conversion of failed gastric banding into four different bariatric procedures.

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