Background

Laparoscopic gastric banding was once more popular than laparoscopic sleeve gastrectomy (LSG) and nearly as popular as Roux-en-Y gastric bypass. Due to unfavorable weight loss rates, many patients have undergone laparoscopic conversion of gastric banding to sleeve gastrectomy or gastric bypass. This study compares the outcomes of patients who underwent band conversion to sleeve gastrectomy with those who underwent primary LSG.

Methods

Retrospective outcomes of conversion-LSG were compared to those of primary-LSG using two patient populations: patients at an MBSAQIP-accredited bariatric center who underwent LSG between 2010 and 2020, and patients that met criteria in the MBSAQIP Data Registry from 2015 to 2018. Patient characteristics, weight loss, and complications were assessed.

Results

Forty-nine patient underwent conversion-LSG, while 827 patients underwent primary-LSG at the accredited center. Percent excess weight loss tended to be lower for the conversion group, even when accounting for weight loss from the gastric band, although this was rarely statistically significant. Rates of 30-day emergency department visits and readmission were not significantly different and complications were infrequent. Patients with conversion-LSG had significantly higher rates of reoperation (1.3% vs. 0.8%, p<0.001), deep surgical site infections (0.08% vs 0.03%, p<0.001), wound disruption (0.08% vs. 0.04%, p=0.01), and post-operative sepsis (0.13% vs. 0.07%, p=0.04) compared to patients with primary-LSG in the MBSAQIP data.

Conclusions

Conclusion: Patients undergoing laparoscopic conversion of gastric banding to sleeve gastrectomy had less robust weight loss compared to those undergoing primary laparoscopic sleeve gastrectomy. However, conversion-LSG is a safe procedure with minimally increased risk compared to primary-LSG.