Conversion to a laparoscopic biliopancreatic diversion with a duodenal switch for failed laparoscopic adjustable silicone gastric banding.

BACKGROUND: Initial data indicate that long-term weight loss for patients who have undergone laparoscopic adjustable silicone gastric banding (LASGB) may be inadequate. It is anticipated that many of these patients will require revision in the next few years. The procedure of choice for such a revision is unknown.

PATIENTS AND METHODS: Two LASGB patients, who underwent a laparoscopic gastric band removal with a conversion to a biliopancreatic diversion with a duodenal switch (BPD/DS), are presented.

RESULTS: Their procedures were completed without intraoperative complications. Significant weight loss over 12 and 13 months was achieved.

CONCLUSION: The BPD/DS, as opposed to the Roux-en-Y gastric bypass (RGB), is well suited for LASGB revision, as its proximal anastomosis is at the duodenum, away from the gastric band scar tissue. Our experience performing laparoscopic BPD/DS has yielded satisfactory weight loss results without the need for revision.