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 ORIGINAL ARTICLE
Year : 2020  |  Volume : 16  |  Issue : 3  |  Page : 264-268

Decreasing complication rates for one-stage conversion band to laparoscopic sleeve gastrectomy: A retrospective cohort study


1 Department of Surgery, Division of Bariatric Surgery, Sacré-Coeur Hospital of Montreal, University of Montreal, Québec H4J 1C5, Canada
2 Montreal Behavioural Medicine Centre, Sacré-Coeur Hospital of Montreal, University of Montreal, 5400 boul. Gouin Ouest Montréal, Québec H4J 1C5, Canada

Correspondence Address:
Dr. Pierre Y Garneau
Hôpital du Sacré-Coeur de Montréal, University of Montréal, 5400 boul. Gouin ouest Montréal, Québec H4J 1C5
Canada
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_86_18

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Background: Laparoscopic adjustable gastric banding (LAGB) revision surgery is often necessary because of its high failure rate. The objective of this study was to demonstrate that better patient selection, when converting a failed LAGB to a laparoscopic sleeve gastrectomy (LSG) as a one-stage revision procedure, is safe, feasible and improves the complication rate. Patients and Methods: A retrospective chart review was performed on patients who underwent a one-stage conversion of failed gastric banding to a LSG. Collected data included age, sex, body mass index (BMI), intraoperative complications, length of stay and post-operative complications. The results were compared to a previous study of 90 cases of LSG as a revision procedure for failed LAGB. Results: There were 75 patients in the current study, 61 women and 14 men, aged 25–67 (average: 46), with a mean BMI of 45 kg/m2 (32–66). Seventy patients (93.3%) were operated for insufficient weight loss and 5 patients (6.7%) for intolerance to the band. In our previous study, 35 patients (39%) were operated for slippage, erosion or obstruction and 14 (15.6%) had post-operative complications as opposed to only 4 patients (5.3%) in this series (P = 0.0359). Gastric leak also improved to 1.3% compared to 5.5% previously. Average hospitalisation time was 2.5 days (1–40). Conclusions: Rigorous patient selection, without band complications such as slippage, erosion or obstruction, allows for a significantly lower rate of operative complications for a one-stage conversion of failed gastric banding to a LSG.






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