J Metab Bariatr Surg.  2017 Dec;6(2):43-48. 10.17476/jmbs.2017.6.2.43.

Re-Banding vs Sleeve Gastrectomy: Technical Reports and Treatment Outcomes of Two Procedures after Removal of Eroded Adjustable Gastric Band

• Kang SH
• Kim SM

• KMID: 2397940
• DOI: http://doi.org/10.17476/jmbs.2017.6.2.43

Abstract

PURPOSE
The aim of the study is to present surgical techniques and treatment outcomes of re-banding and sleeve gastrectomy after removal of eroded adjustable gastric band.
MATERIALS AND METHODS
A retrospective database analysis was performed to study re-banding or LSG as revisional surgery for band erosion. Technical advancement we adopted included adhesiolysis of liver edge and cardia, retrogastric tunneling, and stapling away from fibrotic cardia. Main outcome measures were success of therapeutic strategies, morbidity, and body mass index (BMI), percentage excess weight loss [%EWL] before and after revision.
RESULTS
From 2013 to 2017, a total of 11 patients underwent revisional surgery. Male to female was ratio was 1:10. Six patients underwent revisional sleeve gastrectomy, and five patients underwent re-banding. One patient in sleeve gastrectomy group was diagnosed to have minor leak on CT scan, and recovered by conservative management. The median BMI of the six patients who underwent sleeve gastrectomy was 29.5 kg/m² (27.9 kg/m²-40.8 kg/m²), their median follow-up was 24.8 months (6.5-54.7 months), and their BMI and %EWL at last follow-up was 24.4 kg/m² (22.5 kg/m²-34.6 kg/m²) and 78.4% (19.2%-110.2%) respectively. The median BMI of the five patients who underwent rebanding was 27.3 kg/m² (26.1 kg/m²-41.4 kg/m²), their median follow-up was 16.5 months (4.5-36.4 months), and their BMI and %EWL at last follow-up was 23.5 kg/m² (22.0 kg/m²-30.1 kg/m²) and 83.9% (36.4-123.3%) respectively.
CONCLUSION
With advanced surgical techniques we adopted, both re-banding and sleeve gastrectomy are safe and effective as a revisional procedure after removal of eroded gastric band.

Keyword

Adjustable gastric band; Complication; Sleeve gastrectomy; Revisional surgery

MeSH Terms

Body Mass Index
Cardia
Cytochrome P-450 CYP1A1*
Female
Follow-Up Studies
Gastrectomy*
Humans
Liver
Male
Outcome Assessment (Health Care)
Retrospective Studies
Tomography, X-Ray Computed
Weight Loss
Cytochrome P-450 CYP1A1