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Short-Term (30-Day) Morbidity of Biliopancreatic Diversion Compared to Roux-en-Y Gastric Bypass as Revisional Procedures for Failed Vertical Banded Gastroplasty

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Abstract

Background

Silastic ring vertical gastroplasty (SRVG) and vertical banded gastroplasty (VBG) are associated with a high failure rate due to weight regain and complications at long-term follow-up. Consequently, surgical correction for such procedures is warranted. Controversy exists as to which surgical procedure is the ideal choice for such correction. Our aim is to compare short-term outcome of Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) repair for failed VBG/SRVG bariatric procedures.

Methods

The medical records of patients with failed SRVG who underwent corrective procedures at our institute between 2004 and 2018 were retrospectively reviewed. Patients characteristics, surgical approaches, and intraoperative and post-operative complications were examined and compared.

Results

Sixty patients in total underwent a surgical corrective procedure for failed SRVG. Thirty-one patients underwent RYGB, and 29 patients underwent BPD. Major complications were seen more in the RYGB group (35% = 11) compared to the BPD (6.9% = 2). Even though anastomotic leak rates were not statistically significant (p = 0.053), an apparent tendency for such a complication was noted in the RYGB group. RYGB procedure had an increased 30-day complication rate (p = 0.055) compared to RYGB. Laparoscopic approach had statistically fewer complications than open approach. No mortality was observed in either group.

Conclusion

Our study showed that BPD is a safe option with less complication rates than RYGB in the short-term period for surgical correction of failed VBG/SRVG procedures.

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Data Availability

The data are available from the corresponding author.

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Acknowledgements

The authors thank Mrs. Ronit Leiba for her valuable assistance in the statistical analysis.

Author information

Authors and Affiliations

  1. Department of General Surgery, Rambam Health Care Campus, Haifa, Israel

    Ahmad Mahajna, Daniel Dubin, Miriam Obeid & Ahmad Assalia

  2. Ruth & Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

    Ahmad Mahajna, Daniel Dubin & Ahmad Assalia

  3. Department of General Surgery, Holy Family Hospital, Nazareth, Israel

    Nasser Sakran

  4. Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

    Nasser Sakran

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  1. Ahmad Mahajna
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  4. Nasser Sakran
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Correspondence to Ahmad Mahajna.

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Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was obtained from our institutional Helsinki Committee. Committee’s reference number: 0158–15- RMB.

Consent Statement

Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key Points

• Vertical banded gastroplasty (VBG) is associated with a high failure rate.

• Controversy exists as to which procedure is the ideal choice for failed VBG.

• Short-term outcome of RYGB and BPD repair for failed VBG procedures were compared.

• BPD is a safe option with less complication than RYGB for failed VBG procedures.

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Mahajna, A., Dubin, D., Obeid, M. et al. Short-Term (30-Day) Morbidity of Biliopancreatic Diversion Compared to Roux-en-Y Gastric Bypass as Revisional Procedures for Failed Vertical Banded Gastroplasty. OBES SURG 33, 761–768 (2023). https://doi.org/10.1007/s11695-022-06441-x

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