Revisional Surgery from failed adjustable gastric band to Vertical laparoscopic sleeve Gastrectomy in one surgical time. Case series

Marcos Berry1, Patricio Lamoza2, Lionel Urrutia, MD1, Shirley Marquina1. 1Clinica Las Condes, 2Hospital de Maipu

Introduction

The revision of a failed laparoscopic adjustable gastric banding (LAGB) has become a common scenario in bariatric surgery. The international literature highlights a high morbidity with the conversion of a LAGB to a LSG in one surgical time.

The main objective of this study is to evaluate the results of the conversion in one surgical time of a failed LAGB to LSG.

Method

Prospective case series based on analysis of a database of 1605 patients, between April 2006 and March 2014.

Results

From a universe of 1605 patients subjected to LSG, 77 patients were subjected to a LAGB removal and converted to LSG in one surgical time, representing 4,8%.

Mean age was 40.82 years(18-68), 67% of the patients were female; the mean weight prior to surgery was 95.15 Kg(68.6-144),with a mean BMI of 35(30-44). Co-Morbidities: Insulin resistance 69.8%, Dyslipidemia 58.9% and Fatty liver 53.4%. At 12 months, EWL was 21.3 Kg, with EWL% of 87.3%and a BMI 26.1.At 24 months, EWL was 18.9 kg, with EWL% of 74.7% and BMI of 27.3.

OR time was 91.81 minutes.10 patients (9.59%)had another procedure associated, cholecystectomy and liver biopsies were the most frequent; there were no conversions, no mortality.

Morbidity: 5.1%(3) Patients,1 reoperation for persistent fever, negative laparoscopy,2 bleedings medically treated. There were no leaks.

The average hospital stay was 2.5 days.

Discussion

According to these findings, we conclude that LAGB conversion to LSG in one surgical time is an effective revisional procedure regarding weight loss and safety.

Keywords: Laparoscopic Revisional surgery, Adjustable gastric banding, Sleeve gastrectomy

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