Mohamed D Sarhan1,2, M AbdelSalam N3, Mohamed Saber Mostafa1,2, AbdelRahman Yehia1, Ismail Anwar4, Ehab Fathy1,2. 1. Department of General and Laparoscopic Surgery - Faculty of Medicine, Cairo University, Giza, Egypt. 2. Arab Bariatric and Plastic Center, 15 Amr Street - Al Mohandesin, Giza, Egypt. 3. Arab Bariatric and Plastic Center, 15 Amr Street - Al Mohandesin, Giza, Egypt. m8abdelsalam8m@yahoo.com. 4. Department of Endemic Hepatology and Gastroenterology - Faculty of Medicine, Cairo University, Giza, Egypt.
Abstract
BACKGROUND: Vertical banded gastroplasty (VBG) is now discarded from being a restrictive procedure for morbid obesity due to its many drawbacks, doubtful efficacy, and lots of post-operative complications. Roux-en-Y gastric bypass (RYGB) is the most commonly performed procedure for VBG revision. So we aimed at reporting our experience in conversional RYGB for a failed VBG. MATERIAL AND METHODS: Analyzing follow-up records of 102 patients who underwent revisional RYGB after failed VBG in the period from April 2014 to January 2018. RESULTS: A total of 102 laparoscopic revisions of failed VBGs to RYGB were performed. The mean operating time was 161.9 min ±29.2 and the mean length of the hospital stay was 1.5 days ±1.2. Fourteen patients (13%) developed early post-operative complications (gastrojejunostomy leak 5; bleeding 9). Four patients (4.7%) developed late complications (Port site hernia 2; internal hernia 1; Stomal ulcer 1). The mean BMI pre-RYGB was 46.6 ± 5.9 kg/m2, and the mean %EBWL (percent excess body weight lost) of the patients at 12 and 24 months post-revision were 56.2% and 64.3%, respectively. Our patients had immediate post-revision resolution of VBG-related complications like dysphagia and vomiting. We also report improvement in all obesity-related health problems with (75.7%) complete remission rate and (24.3%) partial remission or improvement rate of diabetes mellitus. CONCLUSION: Conversion of VBG to RYGB is a feasible procedure and is associated with acceptable early morbidity rates and reduced lengths of hospitalization also it provides acceptable weight loss and improvement in obesity-related health problems. Graphical Abstract.
BACKGROUND: Vertical banded gastroplasty (VBG) is now discarded from being a restrictive procedure for morbid obesity due to its many drawbacks, doubtful efficacy, and lots of post-operative complications. Roux-en-Y gastric bypass (RYGB) is the most commonly performed procedure for VBG revision. So we aimed at reporting our experience in conversional RYGB for a failed VBG. MATERIAL AND METHODS: Analyzing follow-up records of 102 patients who underwent revisional RYGB after failed VBG in the period from April 2014 to January 2018. RESULTS: A total of 102 laparoscopic revisions of failed VBGs to RYGB were performed. The mean operating time was 161.9 min ±29.2 and the mean length of the hospital stay was 1.5 days ±1.2. Fourteen patients (13%) developed early post-operative complications (gastrojejunostomy leak 5; bleeding 9). Four patients (4.7%) developed late complications (Port site hernia 2; internal hernia 1; Stomal ulcer 1). The mean BMI pre-RYGB was 46.6 ± 5.9 kg/m2, and the mean %EBWL (percent excess body weight lost) of the patients at 12 and 24 months post-revision were 56.2% and 64.3%, respectively. Our patients had immediate post-revision resolution of VBG-related complications like dysphagia and vomiting. We also report improvement in all obesity-related health problems with (75.7%) complete remission rate and (24.3%) partial remission or improvement rate of diabetes mellitus. CONCLUSION: Conversion of VBG to RYGB is a feasible procedure and is associated with acceptable early morbidity rates and reduced lengths of hospitalization also it provides acceptable weight loss and improvement in obesity-related health problems. Graphical Abstract.
Authors: Peter Vasas; Bruno Dillemans; Sebastiaan Van Cauwenberge; Marieke De Visschere; Charlotte Vercauteren Journal: Obes Surg Date: 2013-02 Impact factor: 4.129
Authors: M R van Wezenbeek; J F Smulders; J P J G M de Zoete; M D Luyer; G van Montfort; S W Nienhuijs Journal: Obes Surg Date: 2015-08 Impact factor: 4.129