• Konstantinos Spaniolas, Andrew T Bates, Salvatore Docimo, Nabeel R Obeid, Mark A Talamini, and Aurora D Pryor.
• Division of Foregut, Bariatric and Advanced GI Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York. Electronic address: konstantinos.spaniolas@stonybrookmedicine.edu.
• Surg Obes Relat Dis. 2017 Nov 1; 13 (11): 1880-1884.

BackgroundThe previous popularity of adjustable gastric banding (AGB), along with inconsistent long-term results, has resulted in the need for conversion to other procedures. The perioperative safety of laparoscopic sleeve gastrectomy (SG) and gastric bypass (RYGB) as single-stage conversion procedures is unclear.ObjectivesTo compare the early safety of SG and RYGB when performed as single-stage conversion procedures at the time of AGB removal.SettingNationwide analysis of accredited centers.MethodsThe Metabolic and Bariatric Surgery Accreditation Quality and Improvement Program public use file for 2015 was queried for all patients who underwent single-stage conversion to SG or RYGB. Multivariable logistic regression was performed to control for baseline differences, and odds ratios (ORs) with 95% confidence intervals are reported.ResultsThere were 4865 patients who underwent a single-stage AGB conversion. SG was performed in 3364 (69.1%). The 30-day reoperation (1.6% versus 2.7%, P = .008), readmission (4% versus 5.7%, P = .006), reintervention (1.7% versus 2.7%, P = .024), and overall morbidity (2.9% versus 6.5%, P<.0001) were significantly less common in the SG group. After controlling for baseline characteristics, RYGB was independently associated with higher overall 30-day reoperation (OR 1.81, 1.19-2.75), readmission (OR 1.42, 1.07-1.88), reintervention (OR 1.59, 1.06-2.4), and overall morbidity (OR 2.17, 1.62-2.9).ConclusionsAGB conversions are associated with low overall 30-day event rates. Patients undergoing RYGB as a single-stage conversion experience higher complication rates and the need for additional early procedures compared with SG.Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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