Laparoscopic Roux-en-Y gastric bypass for failed gastric banding: outcomes in 642 patients.

Details

Serval ID
serval:BIB_74909C32FD96
Type
Article: article from journal or magazin.
Collection
Publications
Title
Laparoscopic Roux-en-Y gastric bypass for failed gastric banding: outcomes in 642 patients.
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Author(s)
Fournier P., Gero D., Dayer-Jankechova A., Allemann P., Demartines N., Marmuse J.P., Suter M.
ISSN
1878-7533 (Electronic)
ISSN-L
1550-7289
Publication state
Published
Issued date
02/2016
Peer-reviewed
Oui
Volume
12
Number
2
Pages
231-239
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Laparoscopic adjustable gastric banding (LAGB) is a well-tolerated procedure but has high long-term complication and failure rates. Laparoscopic conversion to Roux-en-Y gastric bypass (LRYGB) is one of the rescue strategies.
To analyze short- and long-term results of reoperative LRYGB after failed LAGB.
Three European expert bariatric center (2 university hospitals and 1 regional hospital).
A retrospective review of prospectively collected data, including all consecutive patients submitted to revisional LRYGB for failed LAGB between 1999 and 2013, was performed. Complications were classified according to the Dindo-Clavien system. Long-term results in terms of weight loss were analyzed in a subgroup of patients.
A total of 642 patients (569 women and 73 men) were included. Mean±standard deviation operating time was 188±43 minutes. There was no mortality and an overall complication rate of 9.7%, including 3.6% major complications, with no difference between the 1- or 2-step approaches. Follow-up rate was 88% at 10 years for the Swiss patient cohort. The mean excess body mass index loss was between 65% and 70% throughout the study period, and the mean total weight loss was between 28% and 30% based on the maximum weight. The mean body mass index decreased from 44.7 kg/m(2) before LAGB to 31.6, 32.2, and 32.5 kg/m(2) at 1, 5, and 10 years after revision.
Revisional LRYGB is well tolerated and feasible after failed LAGB. A 1-step approach, in cases without erosion, does not increase operative morbidity. Results up to 10 years after revision are comparable to those reported after primary LRYGB.

Keywords
Adult, Female, Follow-Up Studies, Gastric Bypass/methods, Gastroplasty/adverse effects, Humans, Laparoscopy/methods, Male, Obesity, Morbid/surgery, Operative Time, Postoperative Complications/surgery, Reoperation/methods, Retrospective Studies, Time Factors, Treatment Outcome
Pubmed
Create date
27/01/2016 10:05
Last modification date
03/03/2018 18:21
Usage data