Conversion to Gastric Bypass After Either Failed Gastric Band or Failed Sleeve Gastrectomy.
Roux-en-Y gastric bypass (RYGB) is still considered the gold standard in bariatric surgery. Before, adjustable gastric banding (AGB) was regarded as an alternative; nowadays, sleeve gastrectomy (SG) is a more favorable alternative. In case of unsatisfactory results, RYGB is often performed as a secondary procedure. Conversion of an AGB is associated with a high risk of complications; the hypothesis was that this would be less after conversion of an SG.



All patients undergoing conversion to RYGB after AGB or SG between 2005 and 2012 were included for retrospective analysis. Patient characteristics, operative details, postoperative complications, the relief of complaints, weight loss, reasons for failure, and evolution of known comorbidities up to 2 years were analyzed.



A total of 178 patients were included (79.8 % female): AGB 110 (61.8 %) versus SG 68 (38.2 %). Main reasons for conversion were weight regain/insufficient weight loss (48.4 %) or dysphagia/reflux complaints (39.9 %). Surgical complications were found in 19 patients (AGB 13 vs SG 6; p = 0.530). Infectious complications occurred in 13 patients (AGB 11 vs SG 2; p = 0.135). Total body weight loss was equal between groups after 2 years (AGB 31.6 ± 11.0 % vs SG 31.6 ± 12.0 %; p = 0.998). Similar results were found in a subgroup analysis on patients undergoing conversion for additional weight loss (AGB 31.7 ± 11.7 % vs SG 27.0 ± 13.1 %; p = 0.173).



Conversion to RYGB after failed AGB or SG showed comparable short-term results in terms of postoperative complications and weight loss.
Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands. martin.wezenbeek@gmail.com.
M R
MR
van Wezenbeek
Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands.
T R
TR
van Oudheusden
Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands.
J P J G M
JP
de Zoete
Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands.
J F
JF
Smulders
Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands.
S W
SW
Nienhuijs
D000328:Adult; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015430:Weight Gain; D015431:Weight Loss
Gastric bypass; Postoperative complications; Bariatric surgery; Adjustable gastric banding; Sleeve gastrectomy; Redo surgery