Short- and Long-Term Outcomes of Vertical Banded Gastroplasty Converted to Roux-en-Y Gastric Bypass
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Vertical banded gastroplasty (VBG) often necessitates revisional surgery for weight regain or symptoms related to gastric outlet obstruction. Roux-en-Y gastric bypass (RYGB) is considered as the revisional procedure of choice. However, revisional bariatric surgery is associated with relatively higher rates of complications. The aim of the current study is to analyse our single-centre experience with patients requiring revisional RYGB following primary VBG.
Retrospective review of the prospectively collected database identified 153 patients who underwent RYGB as a revisional procedure after VBG from Feb 2004–Feb 2011. Early and late complications, weight data and resolution of symptoms related to gastric outlet obstruction were analysed.
One hundred twenty-three females and 30 males underwent revisional RYGB post VBG. Mean age was 44.4 (15–74) years with a mean pre-operative body mass index (BMI) of 34.2 (23.5–65.5) kg/m2. Mean hospital stay was 4.3 days. Early complication rate was 3.9 % with a 30-day re-operation rate of 1.3 %. Mortality and leak rate were zero. After a mean follow-up of 48 months, the mean BMI decreased significantly to 28.8 kg/m2 and a complete resolution of the obstructive symptoms was achieved in nearly all patients. Late complications developed in 11 (7.7 %) of the patients of which seven (4.9 %) required surgery.
Revisional RYGB following VBG is technically challenging but safe with low rates of morbidity and mortality, comparable to primary RYGB. It produces a significant reduction in body weight and in symptoms resolution. We recommend RYGB as the procedure of choice in patients requiring revisional surgery following VBG.
- Tevis S, Garren MJ, Gould JC. Revisional surgery for failed vertical-banded gastroplasty. Obes Surg. 2011;21(8):1220–4. CrossRef
- Balsiger BM, Poggio JL, Mai J, et al. Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity. J Gastrointest Surg. 2000;4(6):598–605. CrossRef
- Baltasar A, Bou R, Arlandis F, et al. Vertical banded gastroplasty at more than 5 years. Obes Surg. 1998;8(1):29–34. CrossRef
- Miller K, Pump A, Hell E. Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow-up study. Surg Obes Relat Dis. 2007;3(1):84–90. CrossRef
- Scozzari G, Toppino M, Famiglietti F, et al. 10-year follow-up of laparoscopic vertical banded gastroplasty: good results in selected patients. Ann Surg. 2010;252(5):831–9. CrossRef
- Marsk R, Jonas E, Gartzios H, et al. High revision rates after laparoscopic vertical banded gastroplasty. Surg Obes Relat Dis. 2009;5(1):94–8. CrossRef
- Schouten R, Wiryasaputra DC, van Dielen FM, et al. Long-term results of bariatric restrictive procedures: a prospective study. Obes Surg. 2010;20(12):1617–26. CrossRef
- Mason EE. Vertical banded gastroplasty for obesity. Arch Surg. 1982;117(5):701–6. CrossRef
- MacLean LD, Rhode BM, Forse RA. A gastroplasty that avoids stapling in continuity. Surgery. 1993;113(4):380–8.
- Mason EE, Cullen JJ. Management of complications in vertical banded gastroplasty. Curr Surg. 2003;60(1):33–7. CrossRef
- Yale CE. Conversion surgery for morbid obesity: complications and long-term weight control. Surgery. 1989;106(3):474–80.
- Behrns KE, Smith CD, Kelly KA, et al. Reoperative bariatric surgery. Lessons learned to improve patient selection and results. Ann Surg. 1993;218(5):646–53. CrossRef
- Hunter R, Watts JM, Dunstan R, et al. Revisional surgery for failed gastric restrictive procedures for morbid obesity. Obes Surg. 1992;2(3):245–52. CrossRef
- Capella RF, Capella JF. Converting vertical banded gastroplasty to a lesser curvature gastric bypass: technical considerations. Obes Surg. 1998;8(2):218–24. CrossRef
- Dillemans B, Sakran N, Van CS, et al. Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: a single center study on 2606 patients. Obes Surg. 2009;19(10):1355–64. CrossRef
- Mulier JP, Dillemans B, Van CS. Impact of the patient’s body position on the intraabdominal workspace during laparoscopic surgery. Surg Endosc. 2010;24(6):1398–402. CrossRef
- Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37. CrossRef
- Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142(4):621–32. CrossRef
- Cariani S, Agostinelli L, Leuratti L, et al. Bariatric revisionary surgery for failed or complicated vertical banded gastroplasty (VBG): comparison of VBG reoperation (re-VBG) versus Roux-en-Y gastric bypass-on-VBG (RYGB-on-VBG). J Obes 2010; 2010.
- Thill V, Khorassani R, Ngongang C, et al. Laparoscopic gastric banding as revisional procedure to failed vertical gastroplasty. Obes Surg. 2009;19(11):1477–80. CrossRef
- Dargent J. Lap banding as a redo surgery: “restriction over restriction” may be a relevant bariatric strategy. Obes Surg. 2009;19(9):1243–9. CrossRef
- Taskin M, Zengin K, Unal E, et al. Conversion of failed vertical banded gastroplasty to open adjustable gastric banding. Obes Surg. 2001;11(6):731–4. CrossRef
- Gavert N, Szold A, bu-Abeid S. Laparoscopic revisional surgery for life-threatening stenosis following vertical banded gastroplasty, together with placement of an adjustable gastric band. Obes Surg. 2003;13(3):399–403. CrossRef
- Wenger M, Piec G, Branson R, et al. Salvage of gastric restriction following staple-line dehiscence after vertical banded gastroplasty by insertion of an adjustable gastric band. Obes Surg. 2005;15(2):216–22. CrossRef
- Foletto M, Prevedello L, Bernante P, et al. Sleeve gastrectomy as revisional procedure for failed gastric banding or gastroplasty. Surg Obes Relat Dis. 2010;6(2):146–51. CrossRef
- Iannelli A, Schneck AS, Ragot E, et al. Laparoscopic sleeve gastrectomy as revisional procedure for failed gastric banding and vertical banded gastroplasty. Obes Surg. 2009;19(9):1216–20. CrossRef
- Berende CA, de Zoete JP, Smulders JF, et al. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4. CrossRef
- Jacobs M, Gomez E, Romero R, et al. Failed restrictive surgery: is sleeve gastrectomy a good revisional procedure? Obes Surg. 2011;21(2):157–60. CrossRef
- Cariani S, Nottola D, Grani S, et al. Complications after gastroplasty and gastric bypass as a primary operation and as a reoperation. Obes Surg. 2001;11(4):487–90. CrossRef
- Cadiere GB, Himpens J, Bazi M, et al. Are laparoscopic gastric bypass after gastroplasty and primary laparoscopic gastric bypass similar in terms of results? Obes Surg. 2011;21(6):692–8. CrossRef
- Suter M, Ralea S, Millo P, et al. Laparoscopic Roux-en-Y gastric bypass after failed vertical banded gastroplasty: a multicenter experience with 203 patients. Obes Surg 2012 June 15.
- Sadeghi N, Closset J, Houben JJ, et al. Silicon ring vertical gastroplasty for morbid obesity: spectrum of radiologic findings. AJR Am J Roentgenol. 2000;175(1):135–9.
- Gagne DJ, Dovec E, Urbandt JE. Laparoscopic revision of vertical banded gastroplasty to Roux-en-Y gastric bypass: outcomes of 105 patients. Surg Obes Relat Dis. 2011;7(4):493–9. CrossRef
- van Gemert WG, van Wersch MM, Greve JW, et al. Revisional surgery after failed vertical banded gastroplasty: restoration of vertical banded gastroplasty or conversion to gastric bypass. Obes Surg. 1998;8(1):21–8. CrossRef
- Nesset EM, Kendrick ML, Houghton SG, et al. A two-decade spectrum of revisional bariatric surgery at a tertiary referral center. Surg Obes Relat Dis. 2007;3(1):25–30. CrossRef
- Mognol P, Chosidow D, Marmuse JP. Roux-en-Y gastric bypass after failed vertical banded gastroplasty. Obes Surg. 2007;17(11):1431–4. CrossRef
- Iannelli A, Amato D, Addeo P, et al. Laparoscopic conversion of vertical banded gastroplasty (Mason MacLean) into Roux-en-Y gastric bypass. Obes Surg. 2008;18(1):43–6. CrossRef
- Short- and Long-Term Outcomes of Vertical Banded Gastroplasty Converted to Roux-en-Y Gastric Bypass
Volume 23, Issue 2 , pp 241-248
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