title: Revisions after failed gastric band: sleeve gastrectomy and Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Laparoscopic gastric band is an appealing bariatric operation due to its simplicity and good short-term outcomes; however, it is associated with complications (slippage, erosion, prolapse) and failure in reaching target weight loss. This study describes our experience with failed gastric bands that required a revisional procedure.
  
  
  METHODS
  This single-center retrospective analysis includes all consecutive patients who underwent a gastric band removal and revisional surgery in our hospital from January 2008 to June 2014. A total of 81 patients were identified and divided in three groups: Group one included patients who just had the gastric band removed (43), group two consisted of patients who underwent a conversion to sleeve gastrectomy (SG) (26), and group three included patients who required a conversion to Roux-en Y gastric bypass (RYGB) (12). Patient demographics, date of gastric band placement, indications for revision, postoperative morbidity and mortality, operating time, blood loss, length of stay, and % excess weight loss (%EWL) were recorded. Perioperative and clinical outcomes were compared between conversions to SG and RYGB.
  
  
  RESULTS
  In group two (n = 26), 21 conversions to SG were performed in concurrence with the band removal as a one-stage operation, while five procedures were performed in two-stages. There were no complications and no case was converted to open. Patients who underwent a one-stage procedure had a longer operative time, although it did not reach statistical significance. In group three, 12 patients underwent a conversion to RYGB as a revisional operation; 11 were performed as a one-stage procedure and only one patient underwent a two-stage procedure.
  
  
  CONCLUSIONS
  SG and RYGB are safe options to revise a failed gastric band. Both groups who received either a SG or RYGB had a low complication rate and acceptable %EWL with no statistical difference between the two.
authors.affiliation: College of Medicine, University of Illinois at Chicago, 840 South Wood Street, 435 E, Chicago, IL, 60612, USA, rgheredi@uic.edu.
authors.forename: Raquel
authors.initials: R
authors.lastname: Gonzalez-Heredia
authors.forename: Mario
authors.initials: M
authors.lastname: Masrur
authors.forename: Kristin
authors.initials: K
authors.lastname: Patton
authors.forename: Vivek
authors.initials: V
authors.lastname: Bindal
authors.forename: Shravan
authors.initials: S
authors.lastname: Sarvepalli
authors.forename: Enrique
authors.initials: E
authors.lastname: Elli
mesh_terms: D000328:Adult; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D015431:Weight Loss