title: Short- and long-term outcomes of vertical banded gastroplasty converted to Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Vertical banded gastroplasty (VBG) often necessitates revisional surgery for weight regain or symptoms related to gastric outlet obstruction. Roux-en-Y gastric bypass (RYGB) is considered as the revisional procedure of choice. However, revisional bariatric surgery is associated with relatively higher rates of complications. The aim of the current study is to analyse our single-centre experience with patients requiring revisional RYGB following primary VBG.
  
  
  METHODS
  Retrospective review of the prospectively collected database identified 153 patients who underwent RYGB as a revisional procedure after VBG from Feb 2004-Feb 2011. Early and late complications, weight data and resolution of symptoms related to gastric outlet obstruction were analysed.
  
  
  RESULTS
  One hundred twenty-three females and 30 males underwent revisional RYGB post VBG. Mean age was 44.4 (15-74) years with a mean pre-operative body mass index (BMI) of 34.2 (23.5-65.5) kg/m(2). Mean hospital stay was 4.3 days. Early complication rate was 3.9 % with a 30-day re-operation rate of 1.3 %. Mortality and leak rate were zero. After a mean follow-up of 48 months, the mean BMI decreased significantly to 28.8 kg/m(2) and a complete resolution of the obstructive symptoms was achieved in nearly all patients. Late complications developed in 11 (7.7 %) of the patients of which seven (4.9 %) required surgery.
  
  
  CONCLUSIONS
  Revisional RYGB following VBG is technically challenging but safe with low rates of morbidity and mortality, comparable to primary RYGB. It produces a significant reduction in body weight and in symptoms resolution. We recommend RYGB as the procedure of choice in patients requiring revisional surgery following VBG.
authors.affiliation: Department of Bariatric Surgery, AZ Sint Jan Brugge-Oostende AV, Bruges, Belgium. vasasdr@gmail.com
authors.forename: Peter
authors.initials: P
authors.lastname: Vasas
authors.forename: Bruno
authors.initials: B
authors.lastname: Dillemans
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Van Cauwenberge
authors.forename: Marieke
authors.initials: M
authors.lastname: De Visschere
authors.forename: Charlotte
authors.initials: C
authors.lastname: Vercauteren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017211:Treatment Failure; D015431:Weight Loss