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Conversion from band to bypass in two steps reduces the risk for anastomotic strictures

Yves Van Nieuwenhove UGent, Wim Ceelen UGent, KATRIEN VAN RENTERGHEM UGent, DIRK VAN DE PUTTE UGent, TOM HENCKENS UGent and Piet Pattyn UGent (2011) OBESITY SURGERY. 21(4). p.501-505
abstract
Background: Morbidity after converting failed laparoscopic adjustable gastric banding (LAGB) to laparoscopic Roux-en-Y gastric bypass (LRYGB) is three- to fivefold higher than after primary LRYGB. Allowing a time interval between band removal and actual gastric bypass might reduce local inflammation and reduce morbidity. METHODS: This study is a retrospective single-center study of patients who needed conversion to LRYGB because of failed LAGB. Outcomes after conversion of LAGB to LRYGB in one or two steps were compared. RESULTS: Between October 2008 and June 2010, 23 patients had a conversion in one step (group A) while, in 14 patients, the conversion was carried out at least 2 months after band removal (group B). The mean duration of surgery in group A was 150 ± 39 min while it took 181 ± 39 min to complete both steps in group B (p=0.02). Length of stay in group A was 3 (3-8) days, but was 5 (4-8) days for the two steps in group B (p=0.004). During a follow-up of 6-23 months, one pulmonary embolism, one epigastric artery bleeding, and three anastomotic strictures occurred in group A, while no complications were observed in group B. The BMI dropped from 41.4 ± 6.7 to 28.7 ± 10.8 kg/m(2) in group A and from 43.8 ± 5.8 to 35.3 ± 7.55 kg/m(2) in group B. CONCLUSIONS:Operating time and hospital stay are increased when conversion is performed in two steps, but, in this small series, this strategy decreased morbidity and more specifically the rate of anastomotic strictures.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
SECONDARY, Gastric banding, METAANALYSIS, MORTALITY, EXPERIENCE, SURGERY, WEIGHT-LOSS, RESCUE PROCEDURE, LAPAROSCOPIC REVISION, Y GASTRIC BYPASS, REVISIONAL BARIATRIC OPERATIONS, Gastric bypass, Conversion, Stenosis, Two-stage
journal title
OBESITY SURGERY
Obes. Surg.
volume
21
issue
4
pages
501 - 505
Web of Science type
Article
Web of Science id
000288457600013
JCR category
SURGERY
JCR impact factor
3.286 (2011)
JCR rank
17/198 (2011)
JCR quartile
1 (2011)
ISSN
0960-8923
DOI
10.1007/s11695-010-0331-8
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1250101
handle
http://hdl.handle.net/1854/LU-1250101
date created
2011-05-31 21:58:45
date last changed
2011-06-06 08:53:51
@article{1250101,
  abstract     = {Background: Morbidity after converting failed laparoscopic adjustable gastric banding (LAGB) to laparoscopic Roux-en-Y gastric bypass (LRYGB) is three- to fivefold higher than after primary LRYGB. Allowing a time interval between band removal and actual gastric bypass might reduce local inflammation and reduce morbidity. METHODS: This study is a retrospective single-center study of patients who needed conversion to LRYGB because of failed LAGB. Outcomes after conversion of LAGB to LRYGB in one or two steps were compared. RESULTS: Between October 2008 and June 2010, 23 patients had a conversion in one step (group A) while, in 14 patients, the conversion was carried out at least 2 months after band removal (group B). The mean duration of surgery in group A was 150 {\textpm} 39 min while it took 181 {\textpm} 39 min to complete both steps in group B (p=0.02). Length of stay in group A was 3 (3-8) days, but was 5 (4-8) days for the two steps in group B (p=0.004). During a follow-up of 6-23 months, one pulmonary embolism, one epigastric artery bleeding, and three anastomotic strictures occurred in group A, while no complications were observed in group B. The BMI dropped from 41.4 {\textpm} 6.7 to 28.7 {\textpm} 10.8 kg/m(2) in group A and from 43.8 {\textpm} 5.8 to 35.3 {\textpm} 7.55 kg/m(2) in group B. CONCLUSIONS:Operating time and hospital stay are increased when conversion is performed in two steps, but, in this small series, this strategy decreased morbidity and more specifically the rate of anastomotic strictures.},
  author       = {Van Nieuwenhove, Yves and Ceelen, Wim and VAN RENTERGHEM, KATRIEN and VAN DE PUTTE, DIRK and HENCKENS, TOM and Pattyn, Piet},
  issn         = {0960-8923},
  journal      = {OBESITY SURGERY},
  keyword      = {SECONDARY,Gastric banding,METAANALYSIS,MORTALITY,EXPERIENCE,SURGERY,WEIGHT-LOSS,RESCUE PROCEDURE,LAPAROSCOPIC REVISION,Y GASTRIC BYPASS,REVISIONAL BARIATRIC OPERATIONS,Gastric bypass,Conversion,Stenosis,Two-stage},
  language     = {eng},
  number       = {4},
  pages        = {501--505},
  title        = {Conversion from band to bypass in two steps reduces the risk for anastomotic strictures},
  url          = {http://dx.doi.org/10.1007/s11695-010-0331-8},
  volume       = {21},
  year         = {2011},
}

Chicago
Van Nieuwenhove, Yves, Wim Ceelen, KATRIEN VAN RENTERGHEM, Dirk Van de Putte, TOM HENCKENS, and Piet Pattyn. 2011. “Conversion from Band to Bypass in Two Steps Reduces the Risk for Anastomotic Strictures.” Obesity Surgery 21 (4): 501–505.
APA
Van Nieuwenhove, Y., Ceelen, W., VAN RENTERGHEM, K., Van de Putte, D., HENCKENS, T., & Pattyn, P. (2011). Conversion from band to bypass in two steps reduces the risk for anastomotic strictures. OBESITY SURGERY, 21(4), 501–505.
Vancouver
1.
Van Nieuwenhove Y, Ceelen W, VAN RENTERGHEM K, Van de Putte D, HENCKENS T, Pattyn P. Conversion from band to bypass in two steps reduces the risk for anastomotic strictures. OBESITY SURGERY. 2011;21(4):501–5.
MLA
Van Nieuwenhove, Yves, Wim Ceelen, KATRIEN VAN RENTERGHEM, et al. “Conversion from Band to Bypass in Two Steps Reduces the Risk for Anastomotic Strictures.” OBESITY SURGERY 21.4 (2011): 501–505. Print.