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One Versus Two-Step Roux-en-Y Gastric Bypass After Gastric Banding—Data Analysis of the German Bariatric Surgery Registry

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Abstract

Background

Bariatric surgery outcomes have been examined in Germany since January 1, 2005. All data were registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg.

Methods

The data were collected from an online data bank. Data collection began in 2005 for gastric banding (GB) and Roux-en-Y gastric bypass (RYGB) results. In addition to primary bariatric operations, data regarding the complications of revision procedures and redo operations were analyzed. Participation in the quality assurance study was required for all certified centers in Germany.

Results

RYGBs are a popular redo operation after failed gastric banding. In the German Bariatric Surgery Registry (GBSR), we analyzed data from 263 RYGB operations that used a one-step approach after GB and 116 operations that used a two-step approach. The leakage rates for primary RYGB decreased to 1.8 %. The incidence of leakage after a one-step RYGB after GB was lower (1.9 %) than after the two-step procedure (2.6 %).

Conclusion

RYGBs are popular procedures after failed GB in Germany. The multivariable analysis for overall intraoperative complications revealed a significant difference between the two-step and the one-step procedure. In an unadjusted and multivariate assessment, the one-step procedure had statistically lower general postoperative complications than the two-step approach. Therefore, we suggest performing band removal and RYGB as a one-step procedure. Further analysis is necessary to evaluate the risk factors for the one-step procedure. Follow-up investigations must be performed to determine whether RYGB is an effective and safe option after GB.

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Acknowledgments

The German Nationwide Survey on Bariatric Surgery is supported by the Ministry of Research and Education Germany (BMBF) grant number 01GI1124. The responsible investigator is Christine Stroh. The following firms support the GBSR without any relation to their products: Johnson & Johnson MEDICAL GmbH, Ethicon Endo-Surgery Deutschland, Norderstedt Covidien Deutschland GmbH, and Neustadt/Donau. We thank all of the hospitals that participated in this study for their active engagement.

Conflict of Interest

The authors declare that there is no conflict of interest. Christine Stroh, Rudolf Weiner, Stefanie Wolff, Claudia Lerche, Christian Knoll, Thomas Keller, Thomas Manger and Christiane Bruns confirm that there are no links to firms whose products are mentioned in the article or to firms marketing a competing product. The topic is presented in an independent light and the information outlined is product neutral.

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Authors and Affiliations

  1. Department of General, Abdominal and Pediatric Surgery, SRH Municipal Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany

    Christine Stroh & Th. Manger

  2. Sachsenhausen Hospital, Frankfurt/Main, Germany

    R. Weiner

  3. University Hospital, Magdeburg, Germany

    S. Wolff, C. Lerche & C. Bruns

  4. StatConsult, Magdeburg, Germany

    C. Knoll & Th. Keller

  5. Institute for Quality Assurance in Surgical Medicine, University Hospital, Magdeburg, Germany

    Christine Stroh & Th. Manger

Authors
  1. Christine Stroh
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  2. R. Weiner
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  3. S. Wolff
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  4. C. Lerche
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  5. C. Knoll
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  6. Th. Keller
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  7. C. Bruns
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  8. Th. Manger
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Consortia

Obesity Surgery Working Group, Competence Network Obesity

Corresponding author

Correspondence to Christine Stroh.

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Stroh, C., Weiner, R., Wolff, S. et al. One Versus Two-Step Roux-en-Y Gastric Bypass After Gastric Banding—Data Analysis of the German Bariatric Surgery Registry. OBES SURG 25, 755–762 (2015). https://doi.org/10.1007/s11695-014-1527-0

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  • DOI: https://doi.org/10.1007/s11695-014-1527-0

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