Single-stage conversions from failed gastric band to sleeve gastrectomy versus Roux-en-Y gastric bypass: results from the United Kingdom National Bariatric Surgical Registry

Surg Obes Relat Dis. 2018 Oct;14(10):1516-1520. doi: 10.1016/j.soard.2018.06.017. Epub 2018 Jun 30.

Abstract

Background: For patients in whom laparoscopic adjustable gastric band has failed, conversion to Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy are both options for further surgical treatment. There are limited data comparing these 2 procedures. The National Bariatric Surgery Registry is a comprehensive United Kingdom-wide database of bariatric procedures, in which preoperative demographic characteristics and clinical outcomes are prospectively recorded.

Objectives: To compare perioperative complication rate and short-term outcomes of patients undergoing single-stage conversion of gastric band to Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy.

Setting: United Kingdom national bariatric surgery database.

Methods: From the National Bariatric Surgical Registry data set, we identified 141 patients undergoing single-stage conversion from gastric band to either gastric bypass (113) or sleeve gastrectomy (28) between 2009 and 2014, and analyzed their clinical outcomes.

Results: With respect to perioperative outcomes gastric bypass was associated with a higher incidence of readmission or reintervention postoperatively (16 versus 0; P = .04). There was no difference in percentage excess weight loss between sleeve gastrectomy and gastric bypass at final follow-up at 1 year (52.1% versus 57.1% respectively; P = .4).

Conclusions: Conversion from band to sleeve or bypass give comparable good early excess weight loss; however, conversion to sleeve is associated with a better perioperative safety profile.

Keywords: Bariatric surgery; Gastric band; Gastric bypass; Revision surgery; Sleeve gastrectomy.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Bariatric Surgery / adverse effects
  • Bariatric Surgery / methods*
  • Diabetes Complications / surgery
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Gastric Bypass / adverse effects
  • Gastric Bypass / methods
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / surgery
  • Gastroplasty / adverse effects
  • Gastroplasty / methods
  • Humans
  • Hypertension / complications
  • Hypertension / surgery
  • Length of Stay / statistics & numerical data
  • Obesity, Morbid / complications
  • Obesity, Morbid / surgery
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Prospective Studies
  • Registries
  • Reoperation / statistics & numerical data
  • Treatment Failure
  • Treatment Outcome
  • United Kingdom
  • Weight Gain / physiology
  • Weight Loss / physiology