ArticleObesity surgery2021
Outcomes from Explantation of Laparoscopic Adjustable Gastric Band: Experience from a Canadian Bariatric Center of Excellence.
Article in Obesity surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeLaparoscopic adjustable gastric banding (LAGB) has declined in popularity due to poor weight loss and high revision rates. The study aim was to evaluate complication rates following LAGB removals, including conversions to other bariatric procedures. MATERIALS AND
methodsThis was a retrospective cohort study of patients who underwent LAGB removal, identified from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database from the Toronto Western Hospital site. Patients were filtered using principal procedure and concurrent procedural terminology (CPT) codes. Patients converted to other bariatric procedures were also included. Outcomes were evaluated for 30-day morbidity, mortality, readmissions, and costs.
resultsFrom 2012 to 2018, 93 patients met inclusion. 96.77% had elective surgery, and 3.23% were emergent. Thirty-day postoperative complication rate was 11.83%, with 4.30% readmissions and no deaths. Surgical site infections accounted for 81.82% of complications (54.55% superficial, 27.27% deep). Thirty-day complication rate for LAGB removal alone was 17.50% and 33.33% following emergent explantation. 56.99% LAGBs were converted to other bariatric procedures: 48.39% laparoscopic Roux-en-Y gastric bypass (LRYGB) and 8.6% sleeve gastrectomy (LSG). Conversion to LSG had a significantly higher 30-day complication rate (all Clavien-Dindo class I-II) compared to conversion to LRYGB (37.50% versus 2.22%, p < 0.009). Direct costs of LAGB explantation to the healthcare system were $665,443, amounting to $7,155 per patient.
conclusionThirty-day complication rates for LAGB explantation and conversion to other bariatric procedures are significant and may be higher than previously reported for LAGB removal alone. Conversion to LSG may have the highest complication rate, amounting to significant costs.
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