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Vertical Banded Gastroplasty Revision to Gastric Bypass Leads to Effective Weight Loss and Comorbidity and Dysphagia Symptom Resolution

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Abstract

Purpose

Up to 50% of patients with vertical banded gastroplasty (VBG) experience failure or complications in the mid- and long-term and present for revisional bariatric surgery. This study aimed to review our experience for patient outcomes after VBG revisions and compare their benefits to those of primary laparoscopic Roux-en-Y gastric bypass (LRYGB) operations.

Materials and Methods

Data from patients who underwent VBG revision between 2009 and 2015 at a center of excellence were reviewed. Patient demographics, symptoms, comorbidities, weight loss, reinterventions, reoperations, and hospital stay were analyzed and compared with those of primary LRYGB patients (control group).

Results

Fifty-two patients (88.5% female, 55 ± 9.6 years old) underwent revisional surgery during the study period (86.5% LRYGB, 11.5% VBG reversal, and 2% sleeve gastrectomy). Patients presented 17.3 ± 7.2 years after their VBG for weight regain (55.8%), dysphagia (19.2%), or both (25%). Patients who underwent conversion to LRYGB for weight regain and for mix-symptoms had similar weight loss to the control group (38.2 ± 11.8 vs 35.6 ± 7.7, p = 0.108), along with similar comorbidity resolution. However, even though the early (< 30 days) complication rate was similar between the two groups, the conversion group had higher 4-year reoperation rate (29% vs 9.5%, p < 0.001) and length of stay (5.4 ± 5.3 vs 2.6 ± 3.1, p < 0.001). Additionally, dysphagia resolved in all the patients of our cohort.

Conclusions

VBG conversion to LRYGB leads to significant weight loss, resolution of dysphagia, and comorbidities similarly to the primary LRYGB operations. However, higher mid-term complication rates should be expected.

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References

  1. Tevis S, Garren MJ, Gould JC. Revisional surgery for failed vertical-banded gastroplasty. Obes Surg. 2011;21:1220–4.

    Article  Google Scholar 

  2. Gomez CA. Gastroplasty in the surgical treatment of morbid obesity. Am J Clin Nutr. 1980;33:406–15.

    Article  CAS  Google Scholar 

  3. Eckhout GV, Willbanks OL, Moore JT. Vertical ring gastroplasty for morbid obesity. Five year experience with 1,463 patients. Am J Surg. 1986;152:713–6.

    Article  CAS  Google Scholar 

  4. 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;8:21–8.

    Article  Google Scholar 

  5. Desaive C. A critical review of a personal series of 1000 gastroplasties. Int J Obes Relat Metab Disord. 1995;19(Suppl 3):S56–60.

    PubMed  Google Scholar 

  6. Paran H, Shargian L, Shwartz I, et al. Long-term follow-up on the effect of silastic ring vertical gastroplasty on weight and co-morbidities. Obes Surg. 2007;17:737–41.

    Article  Google Scholar 

  7. 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;4:598–605.

    Article  CAS  Google Scholar 

  8. Schouten R, Wiryasaputra DC, van Dielen FM, et al. Long-term results of bariatric restrictive procedures: a prospective study. Obes Surg. 2010;20:1617–26.

    Article  Google Scholar 

  9. Suter M, Jayet C, Jayet A. Vertical banded gastroplasty: long-term results comparing three different techniques. Obes Surg. 2000;10:41–6. discussion 7

    Article  CAS  Google Scholar 

  10. Baltasar A, Bou R, Arlandis F, et al. Vertical banded gastroplasty at more than 5 years. Obes Surg. 1998;8:29–34.

    Article  CAS  Google Scholar 

  11. Schouten R, van Dielen FM, van Gemert WG, et al. Conversion of vertical banded gastroplasty to Roux-en-Y gastric bypass results in restoration of the positive effect on weight loss and co-morbidities: evaluation of 101 patients. Obes Surg. 2007;17:622–30.

    Article  Google Scholar 

  12. Iannelli A, Martini F, Gugenheim J. Laparoscopic conversion of Roux-en-Y gastric bypass to sleeve gastrectomy for intractable marginal ulcer. Surg Obes Relat Dis. 2015;11:262–4.

    Article  Google Scholar 

  13. Westling A, Ohrvall M, Gustavsson S. Roux-en-Y gastric bypass after previous unsuccessful gastric restrictive surgery. J Gastrointest Surg. 2002;6:206–11.

    Article  Google Scholar 

  14. Mognol P, Chosidow D, Marmuse JP. Roux-en-Y gastric bypass after failed vertical banded gastroplasty. Obes Surg. 2007;17:1431–4.

    Article  CAS  Google Scholar 

  15. Mognol P, Chosidow D, Marmuse JP. Laparoscopic conversion of laparoscopic gastric banding to roux-en-Y gastric bypass: a review of 70 patients. Obes Surg. 2004;14:1349–53.

    Article  Google Scholar 

  16. 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;21:692–8.

    Article  Google Scholar 

  17. Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4:353–7.

    Article  CAS  Google Scholar 

  18. Miller K, Pump A, Hell E. Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow-up study. Surg Obes Relat Dis. 2007;3:84–90.

    Article  Google Scholar 

  19. Marsk R, Jonas E, Gartzios H, et al. High revision rates after laparoscopic vertical banded gastroplasty. Surg Obes Relat Dis. 2009;5:94–8.

    Article  Google Scholar 

  20. Cordera F, Mai JL, Thompson GB, et al. Unsatisfactory weight loss after vertical banded gastroplasty: is conversion to Roux-en-Y gastric bypass successful? Surgery. 2004;136:731–7.

    Article  Google Scholar 

  21. Amundsen T, Strommen M, Martins C. Suboptimal weight loss and weight regain after gastric bypass surgery-postoperative status of energy intake, eating behavior, physical activity, and psychometrics. Obes Surg. 2017;27:1316–23.

    Article  Google Scholar 

  22. Conceicao E, Mitchell JE, Vaz AR, et al. The presence of maladaptive eating behaviors after bariatric surgery in a cross sectional study: importance of picking or nibbling on weight regain. Eat Behav. 2014;15:558–62.

    Article  Google Scholar 

  23. Brethauer SA, Kothari S, Sudan R, et al. Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis. 2014;10:952–72.

    Article  Google Scholar 

  24. van Wezenbeek MR, Smulders FJ, de Zoete JP, et al. Long-term results after revisions of failed primary vertical banded gastroplasty. World J Gastrointest Surg. 2016;8:238–45.

    Article  Google Scholar 

  25. 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;7:493–9.

    Article  Google Scholar 

  26. Sugerman HJ, Kellum Jr JM, DeMaria EJ, et al. Conversion of failed or complicated vertical banded gastroplasty to gastric bypass in morbid obesity. Am J Surg. 1996;171:263–9.

    Article  CAS  Google Scholar 

  27. Gonzalez R, Gallagher SF, Haines K, et al. Operative technique for converting a failed vertical banded gastroplasty to Roux-en-Y gastric bypass. J Am Coll Surg. 2005;201:366–74.

    Article  Google Scholar 

  28. Thoreson R, Cullen JJ. Indications and results of reversal of vertical banded gastroplasty (VBG). J Gastrointest Surg. 2008;12:2032–6.

    Article  Google Scholar 

  29. Reoch J, Mottillo S, Shimony A, et al. Safety of laparoscopic vs open bariatric surgery: a systematic review and meta-analysis. Arch Surg. 2011;146:1314–22.

    Article  Google Scholar 

  30. Vasas P, Dillemans B, Van Cauwenberge S, et al. Short- and long-term outcomes of vertical banded gastroplasty converted to Roux-en-Y gastric bypass. Obes Surg. 2013;23:241–8.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr., Indianapolis, IN, 46202, USA

    Dimitrios I. Athanasiadis, Sara Monfared, Jennifer N. Choi, Don Selzer, Ambar Banerjee & Dimitrios Stefanidis

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  1. Dimitrios I. Athanasiadis
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  2. Sara Monfared
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  3. Jennifer N. Choi
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  4. Don Selzer
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  5. Ambar Banerjee
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  6. Dimitrios Stefanidis
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Correspondence to Dimitrios Stefanidis.

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Conflict of Interest

Drs. Dimitrios I. Athanasiadis, Sara Monfared, Jennifer N. Choi, Don Selzer, Ambar Banerjee, and Dimitrios Stefanidis have no conflict of interest.

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Athanasiadis, D.I., Monfared, S., Choi, J.N. et al. Vertical Banded Gastroplasty Revision to Gastric Bypass Leads to Effective Weight Loss and Comorbidity and Dysphagia Symptom Resolution. OBES SURG 30, 3453–3458 (2020). https://doi.org/10.1007/s11695-020-04587-0

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