Safety and Outcome of Laparoscopic Sleeve Gastrectomy Following Removal of Adjustable Gastric Banding: Lessons from 109 Patients in a Single Center and Review of the Literature.

BACKGROUND: Although considered a common bariatric procedure, laparoscopic adjustable gastric banding (LAGB) is associated with high rates of weight loss failure and long-term complications.

PURPOSE: The purpose of this study was to re-assess the safety and outcome of conversion of failed LAGB to laparoscopic sleeve gastrectomy (LSG).

MATERIALS AND METHODS: One hundred and nine patients underwent conversion from LAGB to LSG (78 females, mean age 43 ± 11.3 years, mean BMI 42.4 ± 7.4 kg/m2 ). Patient demographics, obesity-related co-morbidities, BMI before and after the procedure, post-operative complications, and length of hospital stay were documented.

RESULTS: All cases were completed laproscopically, with 88% (n = 96) performed in a single stage. Fourteen patients developed early post-operative complications (12.8%), including two leaks and three post-operative bleeding. There were no mortalities in this series. Average BMI at least 1-year following surgery was 33 ± 5.3 kg/m2 (excess weight loss (EWL) = 53.7%).

CONCLUSIONS: Our data suggests that conversion of failed LAGB to LSG is both safe and effective. Randomized controlled studies comparing conversion of a failed LAGB to sleeve gastrectomy versus other bariatric operations are necessary to clarify the optimal conversion procedure.