title: Two stages conversion of failed laparoscopic adjustable gastric banding to laparoscopic roux-en-y gastric bypass. A study of one hundred patients.
abstract: BACKGROUND
  Conversion to laparoscopic gastric bypass (LRYGB) appears to be the treatment of choice after failed LAGB. To reduce the risk of postoperative complications, some surgeons routinely adopt a two-stage strategy. The purpose of this study was to analyze our institution's experience with the two-stage procedure for LAGB conversion to LRYGB MATERIALS AND METHODS: The bariatric database of our institution was reviewed to identify patients who had undergone conversion of LAGB to LRYGB from November 2007 to June 2012.
  
  
  RESULTS
  One hundred patients were included. Of these, 62 (62%) required conversion to LRYGB for inadequate weight loss or weight regain and 38 for band-related complications. All the procedures were performed in two stages and laparoscopically. The average time between band removal and LRYGB was 17.3 months. The mean follow-up after LRYGB was 31 ± 18.7 months. The mean BMI prior to LRYGB conversion was 45.3 ± 5.2. Early complications occurred in 15 patients (15%), while late complications occurred in only 3 patients (3%). The average %EWL at 24 months and 48 months after conversion was 70.1 and 69.4%, respectively.
  
  
  CONCLUSIONS
  Although a two-stage conversion strategy increases the number of operations and hospital stay without decreasing the rate of early complications compared to one-stage conversion; it has shown to be associated with low rates of GJA stenosis and excellent %EWL.
authors.affiliation: Department of Digestive and Metabolic Surgery, Jean Verdier Hospital, Paris XIII University-University Hospitals of Paris Seine Saint-Denis, Avenue du 14 Juillet, 93140, Bondy, Paris, France, sergio.carandina@jvr.aphp.fr.
authors.forename: Sergio
authors.initials: S
authors.lastname: Carandina
authors.forename: Malek
authors.initials: M
authors.lastname: Tabbara
authors.forename: Manuela
authors.initials: M
authors.lastname: Bossi
authors.forename: Nada
authors.initials: N
authors.lastname: Helmy
authors.forename: Claude
authors.initials: C
authors.lastname: Polliand
authors.forename: Christophe
authors.initials: C
authors.lastname: Barrat
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D017211:Treatment Failure; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
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