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Short- and Long-Term Outcomes of Vertical Banded Gastroplasty Converted to Roux-en-Y Gastric Bypass

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

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References

  1. Tevis S, Garren MJ, Gould JC. Revisional surgery for failed vertical-banded gastroplasty. Obes Surg. 2011;21(8):1220–4.

    Article  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  CAS  Google Scholar 

  3. Baltasar A, Bou R, Arlandis F, et al. Vertical banded gastroplasty at more than 5 years. Obes Surg. 1998;8(1):29–34.

    Article  PubMed  CAS  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  PubMed  Google Scholar 

  8. Mason EE. Vertical banded gastroplasty for obesity. Arch Surg. 1982;117(5):701–6.

    Article  PubMed  CAS  Google Scholar 

  9. MacLean LD, Rhode BM, Forse RA. A gastroplasty that avoids stapling in continuity. Surgery. 1993;113(4):380–8.

    PubMed  CAS  Google Scholar 

  10. Mason EE, Cullen JJ. Management of complications in vertical banded gastroplasty. Curr Surg. 2003;60(1):33–7.

    Article  PubMed  Google Scholar 

  11. Yale CE. Conversion surgery for morbid obesity: complications and long-term weight control. Surgery. 1989;106(3):474–80.

    PubMed  CAS  Google Scholar 

  12. 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.

    Article  PubMed  CAS  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. Capella RF, Capella JF. Converting vertical banded gastroplasty to a lesser curvature gastric bypass: technical considerations. Obes Surg. 1998;8(2):218–24.

    Article  PubMed  CAS  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

  17. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  PubMed  CAS  Google Scholar 

  18. 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.

    Article  PubMed  Google Scholar 

  19. 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.

  20. 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.

    Article  PubMed  Google Scholar 

  21. Dargent J. Lap banding as a redo surgery: “restriction over restriction” may be a relevant bariatric strategy. Obes Surg. 2009;19(9):1243–9.

    Article  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  CAS  Google Scholar 

  23. 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.

    Article  PubMed  Google Scholar 

  24. 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.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. 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.

    Article  PubMed  Google Scholar 

  27. Berende CA, de Zoete JP, Smulders JF, et al. Laparoscopic sleeve gastrectomy feasible for bariatric revision surgery. Obes Surg. 2012;22(2):330–4.

    Article  PubMed  Google Scholar 

  28. 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.

    Article  PubMed  Google Scholar 

  29. 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.

    Article  PubMed  CAS  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. 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.

  32. 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.

    PubMed  CAS  Google Scholar 

  33. 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.

    Article  PubMed  Google Scholar 

  34. 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.

    Article  PubMed  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. Mognol P, Chosidow D, Marmuse JP. Roux-en-Y gastric bypass after failed vertical banded gastroplasty. Obes Surg. 2007;17(11):1431–4.

    Article  PubMed  CAS  Google Scholar 

  37. 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.

    Article  PubMed  Google Scholar 

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Conflict of Interest

All authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Bariatric Surgery, AZ Sint Jan Brugge-Oostende AV, Bruges, Belgium

    Peter Vasas, Bruno Dillemans, Sebastiaan Van Cauwenberge, Marieke De Visschere & Charlotte Vercauteren

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  1. Peter Vasas
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  2. Bruno Dillemans
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  3. Sebastiaan Van Cauwenberge
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  4. Marieke De Visschere
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  5. Charlotte Vercauteren
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Correspondence to Bruno Dillemans.

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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 23, 241–248 (2013). https://doi.org/10.1007/s11695-012-0796-8

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