Complications after gastroplasty and gastric bypass as a primary operation and as a reoperation.
BACKGROUND
Since 1991 we performed vertical banded gastroplasty (VBG) as our surgical treatment of choice for morbid obesity in 680 patients, and since 1996 we also performed Roux-en-Y gastric bypass (RYGB) in 36 patients. For revisional surgery, the surgeons chose procedures based on their experience.


METHODS
We recorded early complications (0.6%) and late complications (8.5%) after the primary operations. When staple-line disruption or stenosis of the banded stoma occurred after VBG, revisional surgery was performed with re-VBG or conversion to RYGBP. Some early complications needed emergency operation for bleeding or gastric perforation.


RESULTS
Mortality was zero. Reoperation with re-VBG and RYGBP was effective in all patients, but for many, a long stay in hospital was necessary because reoperation had a high rate of early and late complications, 33.8% and 21.8% respectively.


CONCLUSIONS
The treatment of complications after VBG with re-VBG and RYGBP had danger. We believe that when VBG failure occurs, to avoid dangerous complications again, we should perform a biliopancreatic diversion, which does not involve a gastric restriction.
Cariani
S
S
Dipartimento di Scienze Chirurgiche ed Anestesiologiche Centro Studi di Terapia Chirurgica dell'Obesità Patologica, Università degli Studi di Bologna, Italy. stefanocariani@hotmail.com
Nottola
D
D
Grani
S
S
Vittimberga
G
G
Lucchi
A
A
Amenta
E
E
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D004630:Emergencies; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D018579:Patient Selection; D012086:Reoperation / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013270:Stomach / Q000293:injuries / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome