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Laparoscopic Adjustable Gastric Banding Revisions in Singapore: a 10-Year Experience

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Abstract

Background

Bariatric surgery is increasingly being carried out and revisional procedures have also risen in concert. A review of the complications and revisions might elucidate technical and patient factors that influence the outcomes of bariatric surgeries in Asian patients. The objective of this study is to review the safety and efficacy of revisional bariatric surgery in a single center in Singapore over a 10-year period.

Methods

The setting of this study is a single public hospital with a multidisciplinary bariatric service including a weight management center, specialized endocrinology services, and bariatric surgical team. Participants were selected for surgery based on body mass index (BMI) and comorbidities. All patients underwent primary laparoscopic adjustable gastric banding (LAGB). Patients were then analyzed according to the types of revisional surgeries. The primary outcome was the type of complications and revisional surgeries. Secondary outcomes include short-term excess weight loss and further complications.

Results

A total of 365 patients were analyzed. 9.6 % had a secondary procedure. In particular, two groups of complications required revisional surgery: failure of sustained weight loss and complications related to the LAGB insertion and use. Revisional surgeries had equivalent major complication rates (5.7 %) compared to primary bariatric surgeries (6.8 %). Revisional surgeries such as revisional LAGB (4.9 ± 9.8 kg), laparoscopic sleeve gastrectomy (LSG; 6.9 ± 21.0 kg), Roux-en-Y gastric bypass (RYGB; 4.6 ± 13.0 kg), and bilio-pancreatic diversion (BPD; 3.5 ± 6.3 kg) had modest weight loss compared to primary weight loss (12.7 ± 9.5 kg). Primary LAGB had a greater percentage excess weight loss in the first and second years post-surgery compared to revisional surgeries. There was one mortality post-primary surgery and no post-revisional surgical mortalities.

Conclusions

Revisional bariatric surgery for complications related to the primary surgery is safe but had reduced excess weight loss compared to the initial surgery.

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References

  1. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial: a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  CAS  PubMed  Google Scholar 

  2. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lee WJ, Chong K, Ser KH, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg. 2011;146(2):143–8.

    Article  PubMed  Google Scholar 

  4. Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–85.

    Article  CAS  PubMed  Google Scholar 

  5. Ikramuddin S, Korner J, Lee WJ, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA. 2013;309(21):2240–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  7. Lomanto D, Lee WJ, Goel R, et al. Bariatric surgery in Asia in the last 5 years (2005-2009). Obes Surg. 2012;22(3):502–6.

    Article  PubMed  Google Scholar 

  8. Bessler M, Daud A, DiGiorgi MF, et al. Adjustable gastric banding as a revisional bariatric procedure after failed gastric bypass. Obes Surg. 2005;15(10):1443–8.

    Article  PubMed  Google Scholar 

  9. Shimizu H, Annaberdyev S, Motamarry I, et al. Revisional bariatric surgery for unsuccessful weight loss and complications. Obes Surg. 2013;23(11):1766–73.

    Article  PubMed  Google Scholar 

  10. Gumbs AA, Pomp A, Gagner M. Revisional bariatric surgery for inadequate weight loss. Obes Surg. 2007;17(9):1137–45.

    Article  PubMed  Google Scholar 

  11. Brolin RE, Cody RP. Weight loss outcome of revisional bariatric operations varies according to the primary procedure. Ann Surg. 2008;248(2):227–32.

    Article  PubMed  Google Scholar 

  12. Clinical Practice Guidelines Obesity. Ministry of Health, Singapore. 2004

  13. Huang CK, Lee YC, Hung CM, et al. Laparoscopic Roux-en-Y gastric bypass for morbidly obese Chinese patients: learning curve, advocacy and complications. Obes Surg. 2008;18(7):776–81.

    Article  PubMed  Google Scholar 

  14. Scopinaro N, Adami GF, Marinari GM, et al. Biliopancreatic diversion. World J Surg. 1998;22(9):936–46.

    Article  CAS  PubMed  Google Scholar 

  15. O’Brien PE, Dixon JB, Laurie C, et al. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg. 2005;15(6):820–6.

    Article  PubMed  Google Scholar 

  16. Jones Jr KB. Revisional bariatric surgery—safe and effective. Obes Surg. 2001;11(2):183–9.

    Article  PubMed  Google Scholar 

  17. Romy S, Donadini A, Giusti V, et al. Roux-en-Y gastric bypass vs gastric banding for morbid obesity: a case-matched study of 442 patients. Arch Surg. 2012;147(5):460–6.

    Article  PubMed  Google Scholar 

  18. Belachew M, Belva PH, Desaive C. Long-term results of laparoscopic adjustable gastric banding for the treatment of morbid obesity. Obes Surg. 2002;12(4):564–8.

    Article  CAS  PubMed  Google Scholar 

  19. O’Brien PE, Dixon JB. Weight loss and early and late complications—the international experience. Am J Surg. 2002;184(6):42–5.

    Article  Google Scholar 

  20. Martikainen T, Pirinen E, Alhava E, et al. Long-term results, late complications and quality of life in a series of adjustable gastric banding. Obes Surg. 2004;14(5):648–54.

    Article  PubMed  Google Scholar 

  21. Biagini J, Karam L. Ten years experience with laparoscopic adjustable gastric banding. Obes Surg. 2009;18(5):573–7.

    Article  Google Scholar 

  22. Stroh C, Birk D, Birk D. A nationwide survey on bariatric surgery in Germany—results 2005-2007. Obes Surg. 2009;19(1):105–12.

    Article  PubMed  Google Scholar 

  23. Dixon JB, O’Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care. 2002;25(2):358–63.

    Article  PubMed  Google Scholar 

  24. Himpens J, Cadiere GB, Bazi M, et al. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146(7):802–7.

    Article  PubMed  Google Scholar 

  25. Campos GM, Rabl C, Roll GR, et al. Better weight loss, resolution of diabetes, and quality of life for laparoscopic gastric bypass vs banding: results of a 2-cohort pair-matched study. Arch Surg. 2011;146(2):149–55.

    Article  PubMed  Google Scholar 

  26. O’Brien PE, MacDonald L, Anderson M, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257(1):87–94.

    Article  PubMed  Google Scholar 

  27. Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. O’Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144(9):625–33.

    Article  PubMed  Google Scholar 

  29. Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity, high long-term complication and failure rates. Obes Surg. 2006;16(7):829–35.

    Article  CAS  PubMed  Google Scholar 

  30. Stroh C, Hohmann U, Schramm H, et al. Fourteen-year long-term results after gastric banding. Journal of Obesity.:article ID128451 2011.

  31. Ngiam KY, Lee WJ, Lee YC, et al. Efficacy of metabolic surgery on HbA1c decrease in type 2 diabetes mellitus patients with BMI <35 kg/m2—a review. Obes Surg. 2014;24(1):148–58.

    Article  PubMed  Google Scholar 

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Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

For this type of study, formal consent is not required.

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Authors and Affiliations

  1. Division of Surgery, University Surgical Cluster, National University Hospital Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 8, 119228, Singapore City, Singapore

    Kee Yuan Ngiam

  2. Department of Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore City, Singapore

    Lucy Kong & Anton Kui Sing Cheng

  3. Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore City, Singapore

    Valerie Yu Hui Khoo

Authors
  1. Kee Yuan Ngiam
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  2. Valerie Yu Hui Khoo
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  3. Lucy Kong
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  4. Anton Kui Sing Cheng
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Correspondence to Kee Yuan Ngiam.

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Ngiam, K.Y., Khoo, V.Y.H., Kong, L. et al. Laparoscopic Adjustable Gastric Banding Revisions in Singapore: a 10-Year Experience. OBES SURG 26, 1069–1074 (2016). https://doi.org/10.1007/s11695-015-1852-y

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