101 - Freie Mitteilung
Bariatry & hernia II
17. Mai 2019, 14:15 - 15:45, Bellavista 5, 6. OG
Mid-term follow-up after laparoscopic revision of gastric bypass for weight loss failure with an adjustable gastric band
I. Lazaridis1, M. Kraljevic1, T. Köstler2, U. Zingg2, T. Delko1, Presenter: I. Lazaridis1 (1Basel, 2Schlieren)
Although laparoscopic Roux-en-Y gastric bypass (LRYGB) is widely accepted as treatment of obesity and its comorbidities, between 20-40% of patients fail to achieve satisfactory long-term weight loss. Several surgical revisional techniques have been introduced to manage failed LRYGB. However, at present, standardized algorhithms for revision for weight loss failure are still lacking. The aim of this study is to review the safety and efficacy of laparoscopic adjustable gastric banding (LAGB) as a revisional procedure after LRYGB due to weight regain or failed weight loss in a single institution.
We conducted a retrospective review of the data of all patients who underwent secondary LAGB with the Minimizer Extra© gastric band after proximal or distal LRYGB between 2011 and 2014 in our institution. The primary outcome was weight loss. Secondary outcomes were morbidity and control of comorbidities.
Twelve patients (n=12) were treated with LAGB during the study period. The mean body mass index (BMI) before LRYGB was 44.8 ± 8 kg/m2. Prerevisional mean BMI was 35.0 ± 3.5 kg/m2 with a 40.4 ± 14.9% mean excess weight loss (EWL). After a mean follow-up of 40.6 ± 20.4 months, the average BMI was 29.4 ± 7 kg/m2 with a mean additional EWL of 28.6± 25.4% and total EWL of 69.1± 25.1%. One patient required band removal because of slippage, two bands needed revision because of disconnection or dislocation and two bands needed refixation because of torsion of the alimentary limb. One patient received conversion into reversion LRYGB with a long biliopancreatic limb due to insufficient weight loss.
LAGB after failed LRYGB shows promising additional weight loss in the mid-term follow-up and therefore may be considered as a valuable option. However, patients must be advised about the high reoperation rate for technical band- related problems.