Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2016; 8(3): 238-245
Published online Mar 27, 2016. doi: 10.4240/wjgs.v8.i3.238
Long-term results after revisions of failed primary vertical banded gastroplasty
Martin R van Wezenbeek, Frans J F Smulders, Jean-Paul J G M de Zoete, Misha D Luyer, Gust van Montfort, Simon W Nienhuijs
Martin R van Wezenbeek, Frans J F Smulders, Jean-Paul J G M de Zoete, Misha D Luyer, Gust van Montfort, Simon W Nienhuijs, Department of Surgery, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands
Author contributions: All authors contributed equally to this manuscript.
Institutional review board statement: This manuscript was approved by the Catharina Hospital Institutional Review Board, Eindhoven, the Netherlands.
Informed consent statement: All involved patients gave their informed consent (written or verbal, as appropriate) to have their data used anonymously for retrospective review prior to their primary bariatric surgery.
Conflict-of-interest statement: None of the authors have anything to disclose that might be a conflict of interest to this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at (email address or URL). Participants gave informed consent for data sharing and data was anonymized.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Martin R van Wezenbeek, MD, Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands. martin.v.wezenbeek@cze.nl
Telephone: +31-402-399850 Fax: +31-402-399859
Received: July 1, 2015
Peer-review started: July 8, 2015
First decision: September 17, 2015
Revised: December 18, 2015
Accepted: January 8, 2016
Article in press: January 11, 2016
Published online: March 27, 2016
Abstract

AIM: To compare the results after revision of primary vertical banded gastroplasty (Re-VBG) and conversion to sleeve gastrectomy (cSG) or gastric bypass (cRYGB).

METHODS: In this retrospective single-center study, all patients with a failed VBG who underwent revisional surgery were included. Medical charts were reviewed and additional postal questionnaires were sent to update follow-up. Weight loss, postoperative complications and long-term outcome were assessed.

RESULTS: A total 152 patients were included in this study, of which 21 underwent Re-VBG, 16 underwent cSG and 115 patients underwent cRYGB. Sixteen patients necessitated a second revisional procedure. No patients were lost-to-follow-up. Two patients deceased during the follow-up period, 23 patients did not return the questionnaire. Main reasons for revision were dysphagia/vomiting, weight regain and insufficient weight loss. Excess weight loss (%EWL) after Re-VBG, cSG and cRYGB was, respectively, 45%, 57% and 72%. Eighteen patients (11.8%) reported postoperative complications and 27% reported long-term complaints.

CONCLUSION: In terms of additional weight loss, postoperative complaints and reintervention rate, Roux-en-Y gastric bypass seems feasible as a revision for a failed VBG.

Keywords: Vertical banded gastroplasty, Conversion, Revision, Gastric bypass, Sleeve gastrectomy, Additional weight loss

Core tip: This study assesses the long-term outcome after revision of a failed vertical banded gastroplasty (VBG). This manuscript compares three types of revision: revision of the primary VBG, conversion to sleeve gastrectomy and conversion to Roux-en-Y gastric bypass. The main finding in this study is that in terms of additional weight loss, postoperative complaints and reintervention rate, Roux-en-Y gastric bypass seems feasible as a revision for a failed VBG.