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Impact of Laparoscopic Banded Gastric Bypass on Weight Loss Surgery Outcomes: 5 Years’ Experience

  • Abdelrahman Mohammad GalalEmail author
  • Evert-Jan Boerma
  • Sofie Fransen
  • Berry Meesters
  • Steven Olde-Damink
  • Magdy Khalil Abdelmageed
  • Alaa Abass Sabry
  • Alaaeldin Hassan M. Elsuity
  • Jan Willem GreveEmail author
Original Contributions
  • 79 Downloads

Abstract

Objective

Evaluate 5-year outcomes of banded gastric bypass (BRYGB) as a primary and conversion bariatric procedure.

Methods

Retrospective review of BRYGB between January 2011and March 2013. Outcomes included percentage of total weight loss (%TWL), weight loss maintenance, and band-related complications.

Results

One hundred forty-two patients underwent BRYGB, 106 primary and 36 conversions. Indications for conversion to BRYGB were complications of the primary procedure (n = 19), insufficient weight loss (n = 5), and weight regain (n = 12). In the primary group, mean preoperative BMI was 44.8 kg/m2 (± 6.9 kg/m2). Compared with preoperative weight, mean %TWL was 33.9% (n = 95), 34.1% (n = 82), 34.0% (n = 70), 33.9% (n = 62), and 31.8% (n = 75) after 1, 2, 3, 4, and 5 years, respectively.

In conversions secondary to failed primary procedure (insufficient WL and weight regain), mean preoperative BMI was 40.8 kg/m2 (± 6.01 kg/m2). Despite one patient gaining weight, mean %TWL was 25.7% (n = 13), 28% (n = 11), 23.9% (n = 8), 18.3% (n = 8), and 15.1% (n = 12) after 1, 2, 3, 4, and 5 years, respectively.

In conversions secondary to primary procedure complications (n = 19), mean preoperative BMI was 28.4 kg/m2 (± 3.5 kg/m2). After 1, 2, 3, 4, and 5 years, mean BMI was 28.1 (n = 15), 29 (n = 10), 29.8 (n = 9), 30.6 (n = 10), and 30.9 (n = 12) kg/m2, respectively.

Band-related complications after 5 years: three erosion and five patients complained of persistent dysphagia. One band needed reposition. Perioperative surgical complications: two bleeding, one leakage, one port-site hernia, and one food impaction.

Conclusion

Banded gastric bypass has good results in terms of weight loss and weight loss maintenance in both primary and conversional bariatric procedures with acceptable incidence of band-related complications.

Keywords

Obesity Bariatric surgery Banded gastric bypass Weight loss Weight maintenance Long term follow up %EWL %TWL Weight regain 

Notes

Acknowledgments

The authors would like to thank the team at the Dutch Obesity Clinic South, Heerlen, The Netherlands, for their support and important assistance for the data collection.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was judged by the Ethics Committee of the Zuyderland Medical Center and was considered not to be Research Involving the Human Subjects Act.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

The study does not include any identifiable information. Retrospective data analysis does not require informed consent; however, all patients gave consent for use of the data before the treatment.

References

  1. 1.
    Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13(41):1–190. 215-357, iii-ivCrossRefGoogle Scholar
  2. 2.
    Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27(9):2279–2289.CrossRefGoogle Scholar
  3. 3.
    Milone M, Di Minno MN, Leongito M, et al. Bariatric surgery and diabetes remission: sleeve gastrectomy or mini-gastric bypass? World J Gastroenterol. 2013;19(39):6590–7.CrossRefGoogle Scholar
  4. 4.
    Kothari SN, Borgert AJ, Kallies KJ, et al. Long-term (>10-year) outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2017;13(6):972–8.CrossRefGoogle Scholar
  5. 5.
    Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.CrossRefGoogle Scholar
  6. 6.
    Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.CrossRefGoogle Scholar
  7. 7.
    Mahawar KK, Parikh C, Carr WR, et al. Primary banded Roux-en-Y gastric bypass: a systematic review. Obes Surg. 2014;24(10):1771–92.CrossRefGoogle Scholar
  8. 8.
    Yimcharoen P, Heneghan HM, Singh M, et al. Endoscopic findings and outcomes of revisional procedures for patients with weight recidivism after gastric bypass. Surg Endosc. 2011;25(10):3345–52.CrossRefGoogle Scholar
  9. 9.
    Capella RF, Capella JF. Converting vertical banded gastroplasty to a lesser curvature gastric bypass: technical considerations. Obes Surg. 1998;8(2):218–24.CrossRefGoogle Scholar
  10. 10.
    Capella JF, Capella RF. An assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity. American journal of surgery. 2002;183(2):117–23.CrossRefGoogle Scholar
  11. 11.
    Fobi M, Conference ABSC. Banded gastric bypass: combining two principles. Surg Obes Relat Dis. 2005;1(3):304–9.CrossRefGoogle Scholar
  12. 12.
    Dillemans B, Van Cauwenberge S, Agrawal S, et al. Laparoscopic adjustable banded Roux-en-Y gastric bypass as a primary procedure for the super-super-obese (body mass index >60 kg/m(2)). BMC surgery. 2010;10:33.CrossRefGoogle Scholar
  13. 13.
    Lemmens L, Karcz WK, Bukhari W, et al. Banded gastric bypass - four years follow up in a prospective multicenter analysis. BMC surgery. 2014;14:88.CrossRefGoogle Scholar
  14. 14.
    Bhandari M, Bhandari S, Mishra A, et al. Comparison between banded and nonbanded Roux-en-Y gastric bypass with 2-year follow-up: a preliminary retrospective analysis. Obes Surg. 2016;26(1):213–8.CrossRefGoogle Scholar
  15. 15.
    Buse JB, Caprio S, Cefalu WT, et al. How do we define cure of diabetes? Diabetes care. 2009;32(11):2133–5.CrossRefGoogle Scholar
  16. 16.
    Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by International Diabetes Organizations. Obes Surg. 2017;27(1):2–21.CrossRefGoogle Scholar
  17. 17.
    Duvoisin C, Favre L, Allemann P, Fournier P, Demartines N, Suter M. Roux-en-Y gastric bypass: ten-year results in a cohort of 658 patients. Ann Surg 2018;268(6):1019–25.CrossRefGoogle Scholar
  18. 18.
    Hunter Mehaffey J, Turrentine FE, Miller MS, et al. Roux-en-Y gastric bypass 10-year follow-up: the found population. Surg Obes Relat Dis. 2016;12(4):778–82.CrossRefGoogle Scholar
  19. 19.
    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(5):622–30.CrossRefGoogle Scholar
  20. 20.
    van Wezenbeek MR, van Oudheusden TR, de Zoete JP, et al. Conversion to gastric bypass after either failed gastric band or failed sleeve gastrectomy. Obes Surg. 2017;27(1):83–9.CrossRefGoogle Scholar
  21. 21.
    Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;08(8):CD003641.Google Scholar
  22. 22.
    Aminian A, Corcelles R, Daigle CR, et al. Critical appraisal of salvage banding for weight loss failure after gastric bypass. Surg Obes Relat Dis. 2015;11(3):607–11.CrossRefGoogle Scholar
  23. 23.
    Irani K, Youn HA, Ren-Fielding CJ, et al. Midterm results for gastric banding as salvage procedure for patients with weight loss failure after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2011;7(2):219–24.CrossRefGoogle Scholar
  24. 24.
    Vijgen GH, Schouten R, Bouvy ND, et al. Salvage banding for failed Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2012;8(6):803–8.CrossRefGoogle Scholar
  25. 25.
    Heneghan HM, Meron-Eldar S, Yenumula P, et al. Incidence and management of bleeding complications after gastric bypass surgery in the morbidly obese. Surg Obes Relat Dis. 2012;8(6):729–35.CrossRefGoogle Scholar
  26. 26.
    Bessler M, Daud A, DiGiorgi MF, et al. Adjustable gastric banding as a revisional bariatric procedure after failed gastric bypass. Obes Surg. 2005;15(10):1443–8.CrossRefGoogle Scholar
  27. 27.
    White S, Brooks E, Jurikova L, et al. Long-term outcomes after gastric bypass. Obes Surg. 2005;15(2):155–63.CrossRefGoogle Scholar
  28. 28.
    Salinas A, Santiago E, Yeguez J, et al. Silastic ring vertical gastric bypass: evolution of an open surgical technique, and review of 1,588 cases. Obes Surg. 2005;15(10):1403–7.CrossRefGoogle Scholar
  29. 29.
    Valezi AC, Mali Junior J, de Menezes MA, et al. Weight loss outcome after silastic ring Roux-en-Y gastric bypass: 8 years of follow-up. Obes Surg. 2010;20(11):1491–5.CrossRefGoogle Scholar
  30. 30.
    Buchwald H, Buchwald JN, McGlennon TW. Systematic review and meta-analysis of medium-term outcomes after banded Roux-en-Y gastric bypass. Obes Surg. 2014 Sep;24(9):1536–51.CrossRefGoogle Scholar
  31. 31.
    Magro DO, Ueno M, Coelho-Neto JS, Callejas-Neto F, Pareja JC, Cazzo E. Long-term weight loss outcomes after banded Roux-en-Y gastric bypass: a prospective 10-year follow-up study. Surg Obes Relat Dis 2018;14(7):910–7.CrossRefGoogle Scholar
  32. 32.
    Lemmens L. Banded gastric bypass: better long-term results? A cohort study with minimum 5-year follow-up. Obes Surg. 2017;27(4):864–72.CrossRefGoogle Scholar
  33. 33.
    Drew RL, Linner JH. Revisional surgery for severe obesity with fascia banded stoma Roux-en-Y gastric bypass. Obes Surg. 1992;2(4):349–54.CrossRefGoogle Scholar
  34. 34.
    Bessler M, Daud A, Kim T, et al. Prospective randomized trial of banded versus nonbanded gastric bypass for the super obese: early results. Surg Obes Relat Dis. 2007;3(4):480–4. discussion 4-5CrossRefGoogle Scholar
  35. 35.
    Lambert EA, Rice T, Eikelis N, et al. Sympathetic activity and markers of cardiovascular risk in nondiabetic severely obese patients: the effect of the initial 10% weight loss. Am J Hypertens. 2014;27(10):1308–15.CrossRefGoogle Scholar
  36. 36.
    McQuigg M, Brown JE, Broom J, et al. The counterweight programme: prevalence of CVD risk factors by body mass index and the impact of 10% weight change. Obes Res Clin Pract. 2008;2(1):I–II.CrossRefGoogle Scholar
  37. 37.
    Laurino Neto RM, Herbella FA, Tauil RM, et al. Comorbidities remission after Roux-en-Y Gastric bypass for morbid obesity is sustained in a long-term follow-up and correlates with weight regain. Obes Surg. 2012;22(10):1580–5.CrossRefGoogle Scholar
  38. 38.
    Fobi M, Lee H, Igwe D, et al. Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Obes Surg. 2001;11(6):699–707.CrossRefGoogle Scholar
  39. 39.
    Awad W, Garay A, Martinez C. Ten years experience of banded gastric bypass: does it make a difference? Obes Surg. 2012 Feb;22(2):271–8.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Surgery DepartmentZuyderland Medical CenterHeerlenThe Netherlands
  2. 2.Dutch Obesity Clinic SouthHeerlenThe Netherlands
  3. 3.Metabolic and Bariatric SurgeryMaastricht University Medical CenterMaastrichtThe Netherlands
  4. 4.General Surgery Department, Sohag Faculty of MedicineSohag University HospitalsSohagEgypt
  5. 5.Surgery department, Ainshams Faculty of MedicineAinshams University HospitalCairoEgypt

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