Abstract:
PURPOSE:The number of laparoscopic adjustable gastric banding (LAGB) removal has increased throughout the years. The aim of the study was to evaluate the outcomes in patients undergoing LAGB removal with or without further bariatric surgery. MATERIALS AND METHODS:Data prospectively collected from consecutive patients undergoing LAGB removal from 2008 to 2016 at our institution were retrospectively analyzed. Obesity-related comorbidities, complications, and body mass index (BMI) before removal and at 1-year follow-up were evaluated. RESULTS:A total of 156 patients were included in the study. Seventy-six patients had further surgery (SURG group): 55 underwent laparoscopic sleeve gastrectomy (LSG) and 21 laparoscopic Roux-en-Y gastric bypass (LRYGB). Eighty patients underwent only LAGB removal (No-SURG group). The mean BMI was lower in the No-SURG group (33.9 vs 36.3 kg/m2, p = 0.0055). Reasons for removal were different in the two groups: dysphagia, frequent vomiting, and LAGB-related complications requiring urgent treatment occurred more commonly in the No-SURG group (p < 0.05): 71.3 vs 51.3%, 67.5% vs. 38.2%, 28.8% vs. 6.6%, respectively. At 1-year follow-up, 96.3% of No-SURG patients regained weight after LAGB removal; two (2.5%) patients showed new-onset comorbidities, four (5%) needed adjustments in pharmacological therapy, and four (5%) complained from persistence of GERD symptoms. Additional surgery provided significant weight loss: the mean %TWL was 23.7% after LSGs and 27.2% after LRYGBs. CONCLUSIONS:LAGB is associated with a high rate of reoperation. Further bariatric surgery after LAGB removal should be considered due to weight regain, persistence of GERD symptoms, and new-onset comorbidities.
journal_name
Obes Surgjournal_title
Obesity surgeryauthors
Genzone A,Ferguglia A,Ambrazevicius M,Toppino M,Grasso L,Allaix ME,Morino Mdoi
10.1007/s11695-018-3373-ysubject
Has Abstractpub_date
2018-11-01 00:00:00pages
3380-3385issue
11eissn
0960-8923issn
1708-0428pii
10.1007/s11695-018-3373-yjournal_volume
28pub_type
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