Correction to: Outcomes After Laparoscopic Conversion of Failed Adjustable Gastric Banding (LAGB) to Laparoscopic Sleeve Gastrectomy (LSG) or Single Anastomosis Duodenal Switch (SADS).

In the original article the Conflict of Interest statement was incomplete. Dr. Roslin discloses that he is a teaching consultant for Ethicon and Medtronics. He also has received research funding from Medtronics.

Outcomes After Laparoscopic Conversion of Failed Adjustable Gastric Banding (LAGB) to Laparoscopic Sleeve Gastrectomy (LSG) or Single Anastomosis Duodenal Switch (SADS).

BACKGROUND: Inadequate weight loss following LAGB (laparoscopic adjusted gastric banding) requiring band removal and conversion to another bariatric procedure is common. There is a paucity of objective data to guide procedure selection. Single anastomosis modifications (SIPS, SADI, SADS) of the duodenal switch biliopancreatic division (DS-BPD) are being investigated. Laparoscopic sleeve gastrectomy (LSG) has become the most prevalent primary bariatric procedure and has been used for revision following LAGB. PURPOSE: The purpose is to investigate single-stage LAGB removal to LSG SADS (single anastomosis duodenal switch). A matched cohort analysis compared each revision to a similar patient having a primary procedure. This was performed to understand the impact of prior banding on outcomes with each procedure. MATERIALS AND METHODS: This is a retrospective study to investigate the outcomes of revision of LAGB for inadequate weight loss to LSG or SADS. To determine whether prior banding impairs results, a matched cohort was done comparing each revision to a patient that had a primary procedure. RESULTS: As expected, patients who had SADS had greater weight loss than LSG. There was no difference in peri-operative and early complications. Both procedures resulted in weight loss. Importantly, with matched cohort, prior LAGB decreased weight loss outcomes in LSG, but not SADS. CONCLUSION: Conversion of LAGB to LSG or SADS results in weight loss. The presence of LAGB decreases weight loss in LSG, but not in SADS. This can have important implications for long-term outcomes.

The incidence of complications associated with loop duodeno-ileostomy after single-anastomosis duodenal switch procedures among 1328 patients: a multicenter experience.

BACKGROUND: The single-anastomosis duodenal switch procedure is a type of duodenal switch that involves a loop anastomosis rather than traditional Roux-en-Y reconstruction. To date, there have been no multicenter studies looking at the complications associated with post-pyloric loop reconstruction. OBJECTIVES: The aim of the study was to report the incidence of complications associated with loop duodeno-ileostomy (DI) following single-anastomosis duodenal switch (SADS) procedures. SETTING: Mixed of private and teaching facilities. METHODS: The medical records of 1328 patients who underwent primary SADS procedure (single-anastomosis duodeno-ileal bypass with sleeve gastrectomy or stomach intestinal pylorus-sparing surgery) by 17 surgeons from 3 countries (United States, Spain, and Australia) at 9 centers over a 6-year period were retrospectively reviewed, and their results were compared with articles in the literature. RESULTS: Mean preoperative body mass index was 51.6 kg/m2. Of 1328 patients, 123 patients received a linear stapled duodeno-ileostomy (DI) and 1205 patients a hand-sewn DI. In the overall series, the anastomotic leak, ulcer, and bile reflux occurred in .6% (9/1328), .1% (2/1328), and .1% (2/1328), respectively. None of our patients experienced volvulus at the DI or an internal hernia. Overall, 5 patients (.3%) (3/123 [2.4%] with linear stapled DI versus 2/1205 [.1%] with hand-sewn DI [P<.05]) experienced stricture at the DI in this series. CONCLUSIONS: The overall incidence of complications associated with loop DI was lower than the reported incidence of anastomotic complications after Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch. SADS procedures may cause much fewer anastomotic complications compared with Roux-en-Y gastric bypass and biliopancreatic diversion with duodenal switch.