Comparison of One Anastomosis Gastric Bypass and Sleeve Gastrectomy for Revision of Laparoscopic Adjustable Gastric Banding: 5-Year Outcomes

Danit Dayan, Anat Bendayan, Nadav Nevo, Eran Nizri, Guy Lahat, Adam Abu-Abeid*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Laparoscopic adjustable gastric banding (LAGB) is in continuous decline due to low effectiveness and high reoperation rates. This study aims to evaluate outcomes of converting LAGB to one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) for insufficient weight loss or weight regain. Materials and Methods: Retrospective comparative study, based on prospective registry database of a tertiary center (2012–2019). Results: In all, 276 LAGB patients were converted to OAGB (n = 125) and SG (n = 151). Body mass index (BMI) at revision was 41.3 ± 6.6 and 42.3 ± 9.6 kg/m2 (P = 0.34) in OAGB and SG patients, respectively. Time interval was longer in OAGB patients (p < 0.001). Major early complication rates were comparable (2.4% and 4%; p = 0.46). At 5-years, OAGB patients had lower BMI (31.9 vs. 34.5 kg/m2; p = 0.002), and a higher total weight loss (25.1% vs. 18.8%; p = 0.003), compared with SG patients. Resolution of type 2 diabetes was higher in OAGB patients (93.3% vs. 66.6%; p = 0.047), while resolution of hypertension was not significantly different (84.6% and 80.5%; p = 0.68). Revision due to delayed complications was required in five (4%) OAGB patients and nine (8.6%) SG patients (p = 0.14). Conclusion: OAGB for revision after LAGB due to insufficient weight loss or weight regain is safe, and has better effectiveness in weight reduction and resolution of type 2 diabetes than SG. Graphical Abstract: [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)1782-1789
Number of pages8
JournalObesity Surgery
Volume33
Issue number6
DOIs
StatePublished - Jun 2023

Keywords

  • Conversion
  • Insufficient weight loss
  • Laparoscopic adjustable gastric banding
  • Metabolic bariatric surgery
  • One anastomosis gastric bypass
  • Revision
  • Sleeve gastrectomy
  • Weight regain

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