Safety and effectiveness of one-stage conversion of adjustable gastric band to sleeve gastrectomy: A single-institution, case-control study

Abstract Background Patients are increasingly referred for conversion of adjustable gastric band (LAGB) to Roux-en-Y gastric bypass (LRYGB) or sleeve gastrectomy (SG). The safety of a 1- versus 2-stage approach to this revision is debated. Objectives We examined the safety and efficacy of 1-stage conversion of LAGB to SG at our institution. Setting University hospital, U.S.A. Methods An institutional database was used to retrospectively identify patients who underwent single-stage LAGB to SG conversion between 2010 and 2018. Patients were matched 1:1 for age, gender, and body mass index (BMI) to primary SG patients during this same period. Primary endpoints were operative time, complication rate, length of hospital say (LOS), and weight loss 12 months from surgery. Results Two hundred and twenty-nine patients undergoing conversion of LAGB to SG were identified. Median postoperative LOS was 2 days. Two patients (0.8%) developed surgical site infection. One patient (0.4%) developed a postoperative myocardial infarction. There were 4 total readmissions (1.7%) and 1 reoperation within 30 days (0.4%). There were no statistically significant differences in 30-day complication rates between groups. Weight loss at 12 months was significantly different: Median BMI loss for conversion patients was 5.1 kg/m2, compared to 8.85 kg/m2 for patients in the primary SG group (p Conclusion Single-stage conversion of LAGB to SG is safe and effective. Patients may not experience the same extent of weight loss as primary SG. Our findings represent the largest single-institutional experience to date and support a 1-stage approach whenever feasible.