One Anastomosis Gastric Bypass as a Revisional Procedure After Failed Laparoscopic Adjustable Gastric Banding

Yonatan Lessing, Nadav Nevo, Niv Pencovich, Subhi Abu-Abeid, David Hazzan, Ido Nachmany, Shai Meron Eldar

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Recent data demonstrates that laparoscopic adjustable gastric banding (LAGB) is found to be associated with high rates of weight loss failure and long-term complications. Therefore, the search for the optimal revisional bariatric procedure is ongoing. Objective: We aim to assess the safety and efficacy of converting a failed LAGB to laparoscopic one anastomosis gastric bypass (OAGB) as a revisional procedure. Setting: Large, metropolitan, tertiary, university hospital. Methods: Retrospective review of patients who underwent OAGB after LAGB.Demographics, comorbidities, BMI before and after the procedure, complications, and length of stay were documented. Results: Fifty-seven patients underwent OAGB after LAGB. For 41 patients, the band was removed, and an OAGB was performed in a single procedure (71.9%), and 96.5% of the cases were completed laparoscopically. Postoperative complications occurred in 9 patients (15.7%), including one mortality. Average BMI decreased from 42.8 ± 7.0 to 31.3 ± 5.2 kg/m2 at least 1 year after surgery, representing a mean %EWL of 64.5%. There was no statistical difference in complication rates between the 1-stage and 2-stage approach. Conclusions: Conversion of a failed LAGB to OAGB is effective but carries higher complication rates. Randomized controlled studies comparing different procedures are necessary to further clarify the optimal revisional bariatric operation.

Original languageEnglish
Pages (from-to)3296-3300
Number of pages5
JournalObesity Surgery
Volume30
Issue number9
DOIs
StatePublished - 1 Sep 2020

Keywords

  • Bariatric surgery
  • LAGB
  • MGB/OAGB
  • Obesity
  • Revisional surgery

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