title: Laparoscopic sleeve gastrectomy (LSG)-a good bariatric option for failed laparoscopic adjustable gastric banding (LAGB): a review of 90 patients.
abstract: BACKGROUND
  Laparoscopic adjustable gastric banding (LAGB) is one of the most frequently performed bariatric surgeries. Even with a high failure rate, revisional procedures such as re-banding or laparoscopic Roux-en-Y gastric bypass (LRYGB) were commonly performed. Recently, conversions of LAGB to laparoscopic sleeve gastrectomy (LSG) were reported. We will review our experience on this conversion.
  
  
  METHODS
  Between February 2007 and January 2012, 800 patients underwent LSG, with 90 as a revisional procedure for failed LAGB. A retrospective review of a prospectively collected database was performed. Data were collected through routine follow-up and weight loss data were also obtained through self-reporting via the Internet. Demographics, complications, and percentage of excess weight loss (%EWL) were determined.
  
  
  RESULTS
  A total of 90 patients underwent LSG as a revisional procedure, comprising of 77 women and 13 men with a mean age of 41 years (22 to 67), a mean body mass index of 42 kg/m(2) (26 to 58). Among them, 15.5 % had diabetes mellitus, 35.5 % had hypertension, 20.0 % had hyperlipidemia, and 18.8 % had obstructive sleep apnea. The mean operative time was 112 min (50 to 220) and mean hospital stay was 4.2 days (1 to 180). Operative complications included 5.5 % leak and 4.4 % hemorrhage or gastric hematoma. There was no postoperative mortality. The mean postoperative %EWL was 51.8 % (n = 82), 61.3 % (n = 60), 61.6 % (n = 45), 53.0 % (n = 30), 55.3 % (n = 20), and 54.1 % (n = 10) at 6, 12, 18, 24, 36, and 48 months, respectively.
  
  
  CONCLUSIONS
  LSG after LAGB yields a positive outcome with higher complication rates than for primary LSG. We advocate this procedure as a good bariatric option for failed LAGB.
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, 5400 boul. Gouin ouest, Montreal, Quebec, Canada, H4J 1C5.
authors.forename: Thierry
authors.initials: T
authors.lastname: Yazbek
authors.forename: Nagi
authors.initials: N
authors.lastname: Safa
authors.forename: Ronald
authors.initials: R
authors.lastname: Denis
authors.forename: Henri
authors.initials: H
authors.lastname: Atlas
authors.forename: Pierre Y
authors.initials: PY
authors.lastname: Garneau
mesh_terms: D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery*; D015992:Body Mass Index; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome; D015431:Weight Loss