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Laparoscopic Conversion of Vertical Banded Gastroplasty (Mason MacLean) into Roux-en-Y Gastric Bypass

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Abstract

Background

Revision of bariatric procedures is required in 10 to 25% of patients either for insufficient weight loss or for complications. Patients undergoing vertical banded gastroplasty (VBG; Mason MacLean) may require revision in up to half of the cases in the long term. Roux-en-Y gastric bypass (RYGBP) is considered the procedure of choice for revision of VBG gastroplasty.

Patients and Methods

Eighteen patients, 16 women and 2 men with a mean age of 41.7 years (range 27–72) and a mean BMI at 37.6 kg/m2 (range 22.5–47), underwent laparoscopic conversion of VBG into RYGBP. Indications for revisional surgery were insufficient weight loss (11 patients), stoma stenosis (4 patients), and acid reflux (3 patients).

Results

Operative time was on average 203 min (range 60–300 min), and conversion was required in one patient (5.5%). There was no early postoperative mortality, and four patients (22.2%) developed immediate postoperative complications (gastrojejunostomy leak 1; stenosis of the gastrojejunal anastomosis 2; liver abscess 1). One patient died 6 months after conversion because of a bleeding anastomotic ulcer (late mortality 5.5%). Two patients (11.5%) developed late complications (incisional hernia 1; internal hernia 1). At a mean follow-up of 23, 4 months BMI is on average 29.8 kg/m2 (range 22.7–37).

Conclusion

Although revision of failed VBG into RYGBP gives good functional results, the risk of postoperative serious complications must be carefully evaluated before revision.

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Authors and Affiliations

  1. Faculté de Médecine, Université de Nice-Sophia-Antipolis, Nice, 06107, France

    Antonio Iannelli, Daniela Amato, Pietro Addeo, Massimo Senni Buratti, Moucef Damhan, Imed Ben Amor, Eric Sejor, Enrico Facchiano & Jean Gugenheim

  2. Centre Hospitalier Universitaire de Nice, Pôle Digestif, Nice, 06202, France

    Antonio Iannelli, Daniela Amato, Pietro Addeo, Massimo Senni Buratti, Moucef Damhan, Imed Ben Amor, Eric Sejor, Enrico Facchiano & Jean Gugenheim

  3. Service de Chirurgie Digestive et Centre de Transplantation Hépatique, Hôpital de l’Archet 2, 151 Route Saint-Antoine de Ginestière, BP 3079, Nice, Cedex 3, France

    Antonio Iannelli, Daniela Amato, Pietro Addeo, Massimo Senni Buratti, Moucef Damhan, Imed Ben Amor, Eric Sejor, Enrico Facchiano & Jean Gugenheim

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  1. Antonio Iannelli
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Correspondence to Antonio Iannelli.

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Iannelli, A., Amato, D., Addeo, P. et al. Laparoscopic Conversion of Vertical Banded Gastroplasty (Mason MacLean) into Roux-en-Y Gastric Bypass. OBES SURG 18, 43–46 (2008). https://doi.org/10.1007/s11695-007-9255-3

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  • DOI: https://doi.org/10.1007/s11695-007-9255-3

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