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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalObesity Surgery
DOIs
StateAccepted/In press - Jan 1 2020

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Keywords

  • Bariatric surgery
  • Comorbidity resolution
  • Revision
  • Vertical banded gastroplasty
  • Weight loss

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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