title: Conversional surgery: single-step conversion of laparoscopic adjustable gastric band to laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  Although some patients attain good outcomes after adjustable gastric band (LAGB), a certain quantity have experienced complications and insufficient weight loss. The objective of this study is to assess the safety and outcome of laparoscopic sleeve gastrectomy (LSG) as a conversion surgery after a failed LAGB.
  
  
  METHODS
  This is a retrospective analysis of 40 patients who received LSG as conversional surgery from 2009 to 2012 in Al Amiri Hospital, Kuwait. Data analyzed included percentage of excessive weight loss (EWL%), body mass index (BMI), and postoperative complications. Paired t test was utilized to evaluate total weight loss after both procedures.
  
  
  RESULTS
  Among the 40 patients that underwent conversion surgery, the mean age was 36 years old, 34 (85 %) of which were females. Follow-up for LAGB was 1 to 11 years (median, 4.5 years) and 6 months to 3 years (median, 1 year) for LSG. Mean BMI before LAGB was 44 kg/m(2) (SD = 7.2) and mean weight was 117.2 kg (SD = 25.1). A percentage of 20 % achieved good outcomes and 7.5 % experienced complications and 60 % insufficient weight loss. Median EWL% achieved with LAGB was 11.5 %, and after LSG, a median EWL% of 56.9 % was recorded. After conversional surgery, a significant drop in BMI was noted with p value < 0.002.
  
  
  CONCLUSIONS
  Laparoscopic conversion from LAGB to LSG may be considered as an alternative for patients with a failed LAGB procedure. However, a longer follow-up study is required to validate the results.
authors.affiliation: Department of Surgery, Al Amiri Hospital, Kuwait City, Kuwait.
authors.forename: N
authors.initials: N
authors.lastname: Al Sharqawi
authors.forename: S
authors.initials: S
authors.lastname: Al Sabah
authors.forename: A
authors.initials: A
authors.lastname: Al Mulla
authors.forename: K
authors.initials: K
authors.lastname: Al Anezi
authors.forename: T
authors.initials: T
authors.lastname: Jumaa
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D015431:Weight Loss; D055815:Young Adult