Vertical banded gastroplasty converted to Roux-en-Y gastric bypass: little impact on nutritional status after 5-year follow-up.
BACKGROUND
Conversion to a Roux-en-Y gastric bypass (RYGBP) has been advocated after the failure of vertical banded gastroplasty (VBG). The aim of this study was to analyze the differences in anthropometric and nutritional parameters between patients with VBG and those converted to RYGBP.


METHODS
45 patients initially underwent VBG. 22 of these patients have maintained this operation for more than 5 years (Group A) and 23 have been converted to RYGBP (Group B), after 2 years of follow-up. We analyzed anthropometric and nutritional parameters (macronutrients,micronutrients and lipid profile), and postoperative morbidity after both procedures. Data were recorded before the first operation and at 6 months, 1, 2 and 5 years follow-up.


RESULTS
VBG failure rate was 51%. The 23 patients converted to RYGBP have maintained an excess weight loss (EWL) of 70% 3 years after the revision, and all the complications related to VBG disappeared. Anthropometric parameters were significantly better after RYGBP. We found no significant differences in nutritional status between both groups except for levels of iron, vitamin B(12) and transferrin saturation index, which significantly decreased in converted patients. The redo procedure had a low morbidity rate, with no mortality.


CONCLUSIONS
More than 50% of VBGs failed after 2-year follow-up. Patients converted to RYGBP maintained mean EWL 73% at 5 years. The only significant nutritional deficiencies were iron and vitamin B(12), in patients converted to RYGBP.
Ortega
Joaquin
J
Department of Surgery, Clinic University Hospital, University of Valencia, Valencia, Spain. joaquin.ortega@uv.es
Sala
Carlos
C
Flor
Blas
B
Jiménez
Elsa
E
Escudero
Maria Dolores
MD
Martinezvalls
Jose
J
Lledo
Salvador
S
D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D008297:Male; D009752:Nutritional Status; D011184:Postoperative Period; D014168:Transferrin / Q000032:analysis; D017211:Treatment Failure; D014805:Vitamin B 12 / Q000097:blood; D015431:Weight Loss
D014168:Transferrin; D014805:Vitamin B 12