Investigators analyzed data for patients undergoing primary bariatric procedures and those undergoing conversion of a previously placed adjustable gastric band between June 2006 and September 2015. In that time, 48,189 patients underwent primary procedures and 1,197 had revisional surgery, including 44 patients converted to gastric bypass, 549 to sleeve gastrectomy, 182 to another adjustable gastric band and 26 to duodenal switch.
Here are four points:
1. When compared with patients who underwent a primary gastric bypass, those who underwent a band-to-bypass conversion had significantly higher adjusted rates of any complication (16.3 percent versus 11.1 percent) and serious complications (6.3 percent versus 3.3 percent).
2. Those who underwent conversion from a band to a sleeve gastrectomy had a higher incidence of any complications (11.9 percent versus 5.8 percent) and more seriously complications (5.3 percent versus 1.9 percent) than those who underwent a primary sleeve gastrectomy.
3. Among sleeve gastrectomy patients, leaks were reported in 0.5 percent of primary and 1.5 percent of revisional band-to-sleeve procedures. Leaks occurred more often in revisional gastric bypass patients at 1.3 percent than primary bypass patients at 0.7 percent.
4. Among the 525 patients who had a revisional procedure for failed weight loss after gastric banding, those who had gastric bypass in a two-stage procedure showed significantly higher rates of any complications (28.7 percent versus 13.8 percent) and readmissions (11.5 percent versus 7.1 percent) than patients who had a one-stage procedure.
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