Background

Adjustable gastric band (AGB) is less effective as sleeve gastrectomy (SG) and roux-en-y gastric bypass (RYGB) for weight loss and has been shown to be associated with long term complications. Patients are increasingly seeking revision surgery after weight recurrence. Our study goal was to compare outcomes following AGB revision to either SG or RYGB.

Methods

An analysis of the 2020 MBSAQIP participant use data file was performed identifying all patients who had single stage revision of AGB to either SG or RYGB for any indication. Patient characteristics, 30-day complications and 30-day weight loss was compared between groups.

Results

Revision surgery was completed in 6131 patients - 3890 to SG and 2241 to RYGB. The two groups had significant difference in age, sex and race but no difference in pre-operative BMI. The operative length was significantly greater for the RYGB group than the SG group. The SG group had significantly more weight loss compared to the BB group. For complications, the RYGB group had significantly higher rates of mortality (0.3 vs 0%), length of stay > 2 days (12.9 vs 5.4%), surgical site infections (2.3 vs 1.0%) and any complication (6.1 vs. 2.7%).

Conclusions

Revision from AGB is offered to different patient populations however BMI does not appear to be a determining factor. Revision from AGB to RYGB appears to have significantly longer operative times, less weight loss and high peri-operative complications. Further research is needed to evaluate which factors cause the band to bypass group to have such differences.