Laparoscopic Sleeve Gastrectomy Following Failed Laparoscopic Adjustable Gastric Banding—a Comparison Between One- and two-Stage Procedures, an Israeli National Database Study

Zvi Perry, Orly Romano-Zelekha, Nasser Sakran, Itzhak Avital, Shahar Atias, Uri Netz, Boris Kirshtein

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: The optimal revisional bariatric surgery procedure following a previous failed gastric band surgery is yet to be determined. The aim of our study was to compare single- and two-stage laparoscopic sleeve gastrectomy (LSG) following laparoscopic adjustable gastric banding (LAGB) in terms of short- and mid-term outcomes. Materials and Methods: Patients who underwent LSG after a failed LAGB in Israel during 2014–2017 were included. Data were obtained from the Israeli National Bariatric Surgery Registry. Data analyzed included comorbidities, postoperative complications, and anthropometric outcomes. Results: Of 595 patients included in the data analysis, 381 (64%) underwent one-stage and 214 (36%) had two-stage LSG. No differences were observed between the groups in complication rates (5.0 vs. 5.1%, p=0.93). Percent of total weight loss was lower following one-stage than two-stage procedure at both 6 months (19.3±9.3 vs. 21.5±8.1%; p=0.02) and 1 year postoperative (24.9±10.4 vs. 27.8±9.9%; p=0.02). No difference was observed in the percent excess weight loss (51 vs. 56%; p=0.34 and 66 vs. 72%; p=0.38, at 6 months and 12 months postoperative, respectively). In a regression analysis, percent excess weight loss was greater in the two-stage procedure (p=0.02), with no difference in the complication rates (p=0.98). Conclusion: Single-step LSG had a similar safety profile as two-stage LSG following a failed LAGB. Better weight loss was seen following two-stage LSG. Further prospective studies should investigate long-term follow-up after one- and two-stage procedure.

Original languageEnglish
Pages (from-to)2364-2372
Number of pages9
JournalObesity Surgery
Volume31
Issue number6
DOIs
StatePublished - 1 Jun 2021
Externally publishedYes

Keywords

  • Laparoscopic sleeve gastrectomy (LSG)
  • Outcomes
  • Postoperative complications
  • Revisional bariatric surgery
  • Single-stage
  • Two-stage

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