Safety and efficacy of adjustable gastric band conversion to laparoscopic sleeve gastrectomy: a retrospective cohort study of a single center’s experience

Background: There is a lack of data in the literature on the conversion of adjustable gastric band (AGB) in Saudi Arabia. The study aims to asses safety and efficacy of AGB single stage conversion at a single center. Methods: A retrospective review at a single center was conducted from January 2017 until January 2021. Patients subjected to one stage conversion of AGB to laparoscopic sleeve gastrectomy (LSG) were included. Conversion patients were matched with comparable patients subjected to primary bariatric surgery in a 1:2 ratio based on age, gender, and comorbidities. Primary endpoints were weight loss after 1 year measured by percentage of total weight loss (%TWL) and percentage of excess body mass index loss (%EBMIL), and complications categorized using Clavien Dindo classification (CDC). Results: Twenty-six patients were managed in a single-stage conversion of AGB to LSG. One third of the patients had weight regain (WR) and band intolerance (BI). Patients converted to LSG had a mean preoperative weight and body mass index (BMI) of 104.9±23.7 kg and 39.2±5.8 kg/m², respectively. One year %TWL and %EBMIL were 26.1%±9.6% and 76.9%±29.7%, respectively. One patient (3%) developed staple line leak and needed readmission, and three patients developed GERD (11%). Primary LSG group had similar preoperative weight (101.9±28.9 kg, P=0.63), BMI (37.7±4.2 kg/m², P=0.34), and comorbidities compared to those in conversion group. After 1 year, primary LSG had better weight loss compared to conversional LSG (P=0.03). Conclusions: Conversion of AGB to other LSG is safe and effective at single centers. WR and BI are the main causes for conversion. Weight loss after conversional LSG is probably inferior to primary LSG so patient education regarding this matter is crucial.