Laparoscopic Roux-en-Y Gastric Bypass for Failed Gastric Banding: One-Step or Two-Step Revisional Surgery?
- PDF / 686,926 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 24 Downloads / 190 Views
ORIGINAL CONTRIBUTIONS
Laparoscopic Roux-en-Y Gastric Bypass for Failed Gastric Banding: One-Step or Two-Step Revisional Surgery? Hefzi Alratrout 1,2
&
Abdullah Almuttawa 2 & Iole Siciliano 3 & Philippe Keller 3
Received: 11 July 2020 / Revised: 29 September 2020 / Accepted: 5 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Surgical revision rates are high, reaching 41% at 10 years after Laparoscopic gastric band (LAGB). Surgical revision may include re-banding, laparoscopic sleeve gastrectomy (LSG), duodenal switch (DS), or laparoscopic Roux-en-Y gastric bypass (LRYGB). LRYGBP has been proposed as the procedure of choice after failure of restrictive procedures with better results than any other procedure. LRYGB as a revisional bariatric surgery is hazardous compared with primary LRYGB. However, controversy as to whether revisional bariatric surgery should be performed as a one-step revision or as a two-step revision. Objective We aim to compare the mortality and morbidity between one-step versus two-step revisional surgery from LAGB to LRYGB. Materials and Methods Retrospective cohort study of our revisional surgery from LAGB to LRYGB between November 2007 and December 2016. Revisional surgery was indicated in cases of inadequate weight loss or weight regain and after band-related complications. Gastric band removal and conversion to LRYGB was either in a one-step or a two-step procedure, according to the indication of this revisional surgery and based on the intra-operative decision. Results One-step group included 107 patients, two-step group had 76 patients. Minor Complications Dindo-Clavien I-II: 5 complication in the one-step group, whereas 4 complication were seen in the two-step group (P = 1.000). Major Complications Dindo-Clavien ≥ IIIa complications: 10 complication in the one-step group, whereas 2 complications in the two-step group (P = 0.127). Conclusion One-step revision is safe and feasible, without significant increased morbidity when performed in a specialized institution. However, proper patient selection is of the utmost importance. Keywords Laparoscopic gastric band . Laparoscopic Roux-en-Y gastric bypass . Revisionla surgery . Morbidity
Introduction Obesity is a global health concern, with bariatric surgery being the most effective therapy for morbid obesity, with sustainable weight loss and improvement in obesity-related comorbidities * Hefzi Alratrout [email protected] 1
Department of General Surgery, College of medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
2
General and Digestive Surgery Department, University of Strasbourg, 1 Avenue Molière, 67200 Strasbourg, France
3
General and Digestive Surgery Department, Hôpital Louis Pasteur, Colmar, France
[1, 2]. Laparoscopic gastric band (LAGB) has been the first bariatric procedure performed by laparoscopy [3]. Since the late 1990s, the simplicity and low postoperative morbidity and mortality rates of LAGB had made it the first choice for weight-loss surgery
Data Loading...
