A Comparison of One- and Two-Stage Laparoscopic Sleeve Gastrectomy Following Failed Laparoscopic Adjustable Gastric Banding Using the BAROS Score

Zvi H. Perry, Tammy Zioni, Uri Netz, Itzhak Avital, Shahar Atias, Alexander Chorny, Boris Kirshtein

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Revision of a failed band can be done by laparoscopic sleeve gastrectomy (LSG). It can be performed synchronously with band removal or during two separate procedures. Aim: Comparing single- and two-staged LSG following a failed LAGB in terms of short- and mid-term outcomes, with an emphasis on postoperative quality of life. Methods: A retrospective cohort study comparing revisional LSG’s safety and efficacy after failed LAGB removal. Data included patients’ medical files, as telephone interviews. We compared demographics, weight loss, complications, long-term outcomes, and quality-of-life measures, including the Bariatric Analysis and Reporting Outcome System (BAROS). Results: Ninety-three patients were enrolled, of which 68 (73.1%) underwent a single-stage revisional LSG. Of these, 40 were males (35.1%) with a mean age of 44.9 years (± 12.9). The two-staged group were older. The reasons for band removal differed between the groups: whereas in the two-stage surgery, the common causes were slippage (29.2%) or band intolerance (25%); in the single-stage group, it was weight gain (51%). There were no differences in short- and mid-term complications, weight loss, and quality of life. Conclusion: In selected cases, laparoscopic sleeve gastrectomy as a revision of failed gastric banding in one stage is as safe as a two-stage procedure in terms of short- and mid-term complications, weight loss, and quality of life. We believe that there is little benefit in performing elective surgery in two stages unless there are clinical indications. Exceptions for two-stage revision should include cases of band erosion and acute slippage with patient preference for band removal. Graphical Abstract: [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)1243-1250
Number of pages8
JournalObesity Surgery
Volume32
Issue number4
DOIs
StatePublished - 1 Apr 2022
Externally publishedYes

Keywords

  • Laparoscopic adjustable gastric band (LAGB)
  • Laparoscopic sleeve gastrectomy (LSG)
  • Outcomes
  • Postoperative complications
  • Quality of life

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