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Long-Term Results of Primary Vertical Banded Gastroplasty

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Abstract

Background

The vertical banded gastroplasty (VBG) used to be a common restrictive bariatric procedure but has been abandoned by many due to a high failure rate, a high incidence of long-term complications, and the newer adjustable gastric band (AGB) and sleeve. However, potential favorable long-term results and the upcoming banded gastric bypass, with a similar mechanical outlet restriction and control of the pouch size, renewed our interest in the VBG. Therefore, we investigated the long-term outcome of primary VBG at the Catharina Hospital in the Netherlands.

Methods

Patients that underwent a primary VBG between 1998 and 2008 were included. Patients’ characteristics, operative details, evolution on weight and comorbidities, complications, and outcome of revisions were reviewed.

Results

A total of 392 patients (80 % female) were reviewed with a mean age of 40 ± 9 years and body mass index of 44 ± 5 kg/m2. Mean follow-up after VBG was 66 ± 50 months and showed a mean excess weight loss (EWL) of 53 ± 27 % and comorbidity reduction of 54 %. One hundred fifty-two patients (39 %) out of 227 patients (58 %) with long-term complaints underwent revisional surgery. Main reasons for revision were weight regain and vomiting/food intolerance. Analysis before revision showed an outlet dilatation (17 %), pouch dilatation (16 %), and outlet stenosis (10 %). After revision, an additional EWL of 23 % and 33 % further reduction in comorbidities was seen.

Conclusions

Primary VBG has an acceptable EWL of 53 % and 55 % of comorbidities were improved. However, the high complication rate, often necessitating revision, underlines the limits of this procedure.

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Conflict of Interest

Two affiliating authors, Dr. Smulders and Dr. Nienhuijs, report an educational grant from Covidien outside the submitted work. Dr. van Wezenbeek, Dr. de Zoete, Dr. Luyer, and Dr. van Montfort have nothing to disclose.

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Authors and Affiliations

  1. Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands

    M. R. van Wezenbeek, J. F. Smulders, J. P. J. G. M. de Zoete, M. D. Luyer, G. van Montfort & S. W. Nienhuijs

Authors
  1. M. R. van Wezenbeek
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  2. J. F. Smulders
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  3. J. P. J. G. M. de Zoete
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  4. M. D. Luyer
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  5. G. van Montfort
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  6. S. W. Nienhuijs
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Corresponding author

Correspondence to M. R. van Wezenbeek.

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van Wezenbeek, M.R., Smulders, J.F., de Zoete, J.P.J.G.M. et al. Long-Term Results of Primary Vertical Banded Gastroplasty. OBES SURG 25, 1425–1430 (2015). https://doi.org/10.1007/s11695-014-1543-0

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  • DOI: https://doi.org/10.1007/s11695-014-1543-0

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