One Versus Two-Step Roux-en-Y Gastric Bypass After Gastric Banding—Data Analysis of the German Bariatric Surgery Registry

Weiner, R; Wolff, Stefanie; Lerche, Christian; Knoll, C.; Keller, Thomas; Bruns, Christiane; Manger, Th.

doi:10.1007/s11695-014-1527-0

Cited by 22 publications

(2 citation statements)

References 14 publications

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“…No consensus exists among the scientific community on this issue. While the American Society for Metabolic and Bariatric Surgery (ASMBS) revision surgery task force published a systematic review in 2014 indicating that two-step revision of LAGB to RYGB is safer than a one-step approach [7], there are multiple reports in the literature citing that a single-step RYGB conversion is safe except when there is intra-gastric band erosion [6,[8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Conversion of Adjustable Gastric Banding to Roux-en-Y Gastric Bypass in One or Two Steps: What Is the Best Approach? Analysis of a Multicenter Database Concerning 832 Patients

Pujol-Rafols¹,

Abbas

Devriendt

et al. 2020

OBES SURG

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Background Roux-en-Y gastric bypass (RYGB) is often the preferred conversion procedure for laparoscopic adjustable gastric banding (LAGB) poor responders. However, there is controversy whether it is better to convert in one or two stages. This study aims to compare the outcomes of one and two-stage conversions of LAGB to RYGB. Methods Retrospective review of a multicenter prospectively collected database. Data on conversion in one and two stages was compared. Results Eight hundred thirty-two patients underwent LAGB conversion to RYGB in seven specialized bariatric centers. Six hundred seventy-three (81%) were converted in one-stage. Patients in the two-stage group were more likely to have experienced technical complications, such as slippage or erosions (86% vs. 37%, p = 0.0001) and to have had a higher body mass index (BMI) (41.6 vs. 39.9 Kg/m 2 , p = 0.005). There were no differences in postoperative complications and mortality rates between the onestage and two-stage groups (13.5% vs. 10.8%, and 0.7% vs. 0.0% respectively, p = ns). Mean final BMI and %total weight loss (%TWL) for the one-stage and the two-stage groups were 31.6 vs. 32.4 Kg/m 2 (p = ns) and 30.4 vs. 26.8 (p = 0.017) after a mean follow-up of 33 months. Follow-up at 1, 3, and 5 years was 98%, 75%, and 54%, respectively. Conclusions One-stage conversion of LAGB to RYGB is safe and effective. Two-stage conversion carries low morbidity and mortality in the case of band slippage, erosion, or higher BMI patients. These findings suggest the importance of patient selection when choosing the appropriate conversion approach.

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Section: Introductionmentioning

confidence: 99%

Conversion of Adjustable Gastric Banding to Roux-en-Y Gastric Bypass in One or Two Steps: What Is the Best Approach? Analysis of a Multicenter Database Concerning 832 Patients

Pujol-Rafols¹,

Abbas

Devriendt

et al. 2020

OBES SURG

View full text Add to dashboard Cite

show abstract

“…Our results were equivalent between the two groups, although the study was underpowered for this question. Numerous papers have assessed this question with equivocal results …”

Section: Discussionmentioning

confidence: 99%