Al-Kurd A, et al. - Researchers compared the complication rates and outcomes between laparoscopic adjustable gastric banding (LAGB) converted to Laparoscopic Roux-en-Y gastric bypass (LRYGB) and primary LRYGB. Despite longer operating time, revision of LAGB to LRYGB proved to be a safe procedure, with similar complication rates when compared to primary LRYGB. Although less weight loss was evident with revisional LRYGB than primary LRYGB, the procedure’s safety makes it a very plausible option as a rescue operation for failed LAGB.

Methods

• Researchers performed a retrospective analysis in all patients converted from LAGB to LRYGB between January 2007 and March 2017.
• A comparison of this group was performed to a matched cohort of primary LRYGB patients operated during the same period.
• They performed analysis of early and late complications, weight loss, and improvement of comorbidities.

Results

• Comparison of 161 revisional LRYGB patients to a similar number of primary LRYGB patients was performed.
• The groups were comparable in terms of preoperative age, gender distribution, weight, and BMI.
• In the revisional group, mean operative time was longer (137.7 vs. 112.7 min, respectively, P < 0.001).
• The groups were comparable in terms of the overall early complication rates (7.5 vs. 11.8%, P=0.16), including postoperative leak rate (0.62%). In 78% of the patients, follow-up of at least 6 months was attained.
• Revisional cases showed less weight loss (61.5 vs. 73.5%EWL, respectively, P=0.004) and slightly less improvement of comorbidities (75.0 vs. 85.7%, respectively, P=0.09).
• Comparable late complication rate was observed (8.1 vs. 8.1%, P=1.0).