SP7.04 Meta-analysis of gastric band conversion to sleeve gastrectomy versus to Roux-en-Y gastric bypass

Aims To evaluate comparative outcomes of gastric band conversion to sleeve gastrectomy (SG) versus to Roux-en-Y gastric bypass (RYGB). Methods The study protocol was prospectively registered in PROSPERO. A systematic search of MEDLINE, CENTRAL and Web of Science and bibliographic reference lists were conducted. All comparative studies reporting outcomes of gastric band conversion to SG or RYGB were included, and their risk of bias were assessed. Percent excess body weight loss (%EWL) at 6 months, 1-year and 2-years, postoperative morbidities and mortality were the evaluated outcome parameters. Results Nineteen comparative studies reporting a total of 19,532 patients who gastric band conversion to SG (n-=10,646) or RYGB (n= 8,886) were included. Although conversion to SG and RYGB had comparable %EWL at 6 months (MD -3.44; 95% CI -10.66-3.78, p=0.35), conversion to RYGB was associated with significantly higher %EWL at 1-year (MD -7.69; 95% CI -12.02- -3.35, p=0.0005), and 2-years (MD -11.18; 95% CI -21.41-0.95, p=0.03), compared with conversion to SG. There was no significant difference in perioperative morbidities (OR 0.65; 95% CI 0.27-1.58, p=0.35) or mortality (RD 0.00; 95% CI -0.00-0.00, p=0.39) between two groups. Conclusions The meta-analysis of best available evidence demonstrated that gastric band conversion to RYGB is associated with significantly higher % EWL compared with its conversion to SG without increasing perioperative morbidity or mortality.