title: Single-center experience in single-stage conversions of gastric banding to sleeve gastrectomy: is it as safe as 2-stage conversions?
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) can be performed after obesity persistence following laparoscopic adjustable gastric banding (LAGB) with a positive safety profile. However, some argue that the conversion should be performed in 2 stages rather than 1 because of perioperative complications. The aim of this study is to determine the safety profile of single-stage LAGB to LSG conversion.
  
  
  METHODS
  Academic hospital, United States.
  
  
  METHODS
  From October 2009 to July 2016, a total of 76 patients underwent conversions to a LSG because of obesity persistence after LAGB. Of these cases, 65 were done as single-stage procedures and 11 were done in 2 stages. Perioperative complications were compared between the 1-stage and 2-stage conversion groups.
  
  
  RESULTS
  Mean operative time was 122.5±26.1 minutes (range, 75-186) in the single-stage group and 103.6±29.7 minutes (range, 66-145) in the 2-stage group (P>0.08). Mean length of hospital stay was 1.5±.6 days (range, 1-3) in the single-stage group and 1.6±.7 days (range, 1-3) in the 2-stage group (sleeve gastrectomy portion) (P> .58). Two patients (3.1%) in the single-stage group required readmission within 60 days after the conversion because of dehydration (n = 1) and abdominal wall cellulitis (n = 1). Both patients were treated conservatively, and no patient in the 2-stage group required readmission within 60 days from LSG. No patient required reoperation within 60 days, and no patient developed a staple line leakage during the period of follow-up.
  
  
  CONCLUSIONS
  Single-stage laparoscopic conversion of LAGB to LSG is feasible and, in appropriately selected patients, does not seem to increase the risk of complications compared with 2-stage procedures.
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, Florida.
authors.forename: Rena C
authors.initials: RC
authors.lastname: Moon
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, Florida.
authors.forename: Jameson
authors.initials: J
authors.lastname: Wier
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, Florida.
authors.forename: Romulo
authors.initials: R
authors.lastname: Lind
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, Florida.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Teixeira
authors.affiliation: Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, Florida. Electronic address: muhammad.jawad@orlandohealth.com.
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Jawad
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D061646:Operative Time; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: 2 stage; Conversion; Gastric band; Single stage; Sleeve gastrectomy