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    • Short Term Results of Revisional Laparoscopic Bariatric Surgery after Open Vertical Banded Gastroplasty (VBG): Sleeve Versus Bypass

    Mohamed Abd El-Moneim El-Masry(MD); Hussein Oukasha(MD)
    Department of General Surgery, Faculty of Medicine, Cairo University – Egypt Department of Internal Medicine, Faculty of Medicine, Cairo University – Egypt

    Vertical banded gastroplasty (VBG) considered by some surgeons as a valuable bariatric surgical option. The rate of failure of VBG was high in the long term due to specific complications. Many patients who had previously undergone a VBG need a revision to other bariatric surgeries, including Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or the biliopancreatic diversion with duodenal switch (BPD-DS). Methods: This prospective study included fourteen morbidly obese patients with history of previous open vertical banded gastroplasty. These patients underwent laparoscopic revisional bariatric surgery either, laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) between January 2011 & August 2014. Patients were evaluatedby history, clinical examination and investigations. They followed up for short-term results over a period of 2 years after the operation for postoperative complications as bleeding, leakage and infection and for weight loss after 2 years. Results: The mean age of patients was 35 years. The majority of patients in this study (92.9%) were females. The duration between last VBG and revisional surgery ranged from two to six years with the mean of 4 years. The basic body mass index (BMI) of all patients in this study (before revisional surgery) ranged from 36.4 to 69.4 kg/m2 with a mean of 47.3 kg/m2. After 2 years, all patients’ BMI ranged from 25.2 to 36.7 kg/m2 with a mean of 30.0 kg/m2. Regarding excess weight loss percentage (% EWL), the overall % EWL ranged from 57.4 % to 98.2 % with a mean of 78.7 %. In this study, there was no patients converted to laparotomy. There was no mortality in this study either intra or post-operative or during 2 years follow-up. The operative time of both groups ranged from 135 to 255 minutes with a mean of 184 minutes. Postoperatively, we had only one patient from group (A) developed gastric leakage (7 %). The hospital stay ranged from one to seven days with a mean of two days. Conclusion: Conversion of VBG to other bariatric procedures was not an easy procedure that required an experienced team. Weight loss percentage of these revisional surgeries was the same as the primary ones. There was no clear difference between conversion from VBG to either sleeve gastrectomy or Roux-en-Y gastric bypassregarding weight loss percentage or operative time. Key words: VBG, Laparoscopic sleeve gastrectomy, Morbid obesity, Revisional bariatric surgery, Open vertical banded gastroplasty, Roux-en-Y gastric bypass, VBG conversion . 

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