Banded gastric bypass - four years follow up in a prospective multicenter analysis

BMC Surgery

Simon Kuesters⁴  Jodok Fink⁴  Waleed Bukhari¹  W Konrad Karcz³  Luc Lemmens² 

[1] International Medical Centre, Jeddah, Kingdom of Saudi Arabia;Antwerp Medical Center, Antwerp 2000, Belgium;Department of Surgery, University of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany;Department of General and Visceral Surgery, University of Freiburg, Freiburg, Germany

关键词: Bariatric surgery;    Gastric banding;    Restriction;    Banded gastric bypass;    Gastric bypass;   

Others  :  1091349
DOI  :  10.1186/1471-2482-14-88

 received in 2013-10-29, accepted in 2014-10-17,  发布年份 2014

【 摘 要 】

Background

The gastric bypass is the gold standard of bariatric surgery. Nevertheless some patients show insufficient weight loss or weight regain. Dilation of the pouch or the pouch outlet may be the cause. The banded gastric bypass tries to overcome dilation by placing an implant around the pouch or pouch outlet. In this study we describe our results using the GaBP™ ring system in banded gastric bypass operations in 3 bariatric centers.

Methods

183 patients in 3 bariatric reference centers received a banded gastric bypass operation using the GaBP™ ring system. Up to 4 years follow up was evaluated including weight loss and complications.

Results

Mean EWL after 6 Months was 60% with a mean BMI of 30.1 kg/m². After one year mean EWL reached 75.3% with a mean BMI of 27 kg/m² (110 patients). After two and three years the EWL was 78.8% (n = 49) and 79.9% (n = 35). There was a mean EWL of 85% after 4 years. Thirteen patients finished a 4 year follow up period and mean BMI after 4 years was 25.2 kg/m². In the perioperative and early postoperative period there was a low complication rate (4.3%). Stenosis or dysphagia was observed in only one patient. There was only one ring related complication.

Conclusion

Banded gastric bypass using the GaBP™ ring system allows good weight loss with no regain of weight in a four year follow up. The complication rate is low. A randomized controlled trial is currently underway to compare banded and conventional gastric bypass.

【 授权许可】

   
2014 Lemmens et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Fisher BL, Barber AE: Gastric bypass procedures. Eur J Gastroenterol Hepatol 1999, 11(2):93-97.
• [2]Buchwald H, Oien DM: Metabolic/bariatric surgery Worldwide 2008. Obes Surg 2009, 19(12):1605-1611.
• [3]Garb J, Welch G, Zagarins S, Kuhn J, Romanelli J: Bariatric surgery for the treatment of morbid obesity: a meta-analysis of weight loss outcomes for laparoscopic adjustable gastric banding and laparoscopic gastric bypass. Obes Surg 2009, 19(10):1447-1455.
• [4]Pontiroli AE, Morabito A: Long-term prevention of mortality in morbid obesity through bariatric surgery. a systematic review and meta-analysis of trials performed with gastric banding and gastric bypass. Ann Surg 2011, 253(3):484-487.
• [5]Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K: Bariatric surgery: a systematic review and meta-analysis. JAMA 2004, 292(14):1724-1737.
• [6]Christou NV, Look D, Maclean LD: Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg 2006, 244(5):734-740.
• [7]Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC: Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg 2008, 18(6):648-651.
• [8]Yimcharoen P, Heneghan HM, Singh M, Brethauer S, Schauer P, Rogula T, Kroh M, Chand B: Endoscopic findings and outcomes of revisional procedures for patients with weight recidivism after gastric bypass. Surg Endosc 2011, 25(10):3345-52.
• [9]Karcz WK, Kuesters S, Marjanovic G, Suesslin D, Kotter E, Thomusch O, Hopt UT, Felmerer G, Langer M, Baumann T: 3D-MSCT gastric pouch volumetry in bariatric surgery-preliminary clinical results. Obes Surg 2009, 19(4):508-516.
• [10]Madan AK, Tichansky DS, Phillips JC: Does pouch size matter? Obes Surg 2007, 17(3):317-320.
• [11]Roberts K, Duffy A, Kaufman J, Burrell M, Dziura J, Bell R: Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc 2007, 21(8):1397-1402.
• [12]Blanchet MC, Mesmann C, Yanes M, Lepage S, Marion D, Gelas P, Gouillat C: 3D gastric computed tomography as a new imaging in patients with failure or complication after bariatric surgery. Obes Surg 2010, 20(12):1727-1733.
• [13]Fobi MA, Lee H: The surgical technique of the Fobi-Pouch operation for obesity (the transected silastic vertical gastric bypass). Obes Surg 1998, 8(3):283-288.
• [14]Capella JF, Capella RF: An assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity. Am J Surg 2002, 183(2):117-123.
• [15]Fobi MA: Placement of the GaBP ring system in the banded gastric bypass operation. Obes Surg 2005, 15(8):1196-1201.
• [16]Gumbs AA, Margolis B, Bessler M: Laparoscopic banded-Roux-en-Y gastric bypass. Surg Obes Relat Dis 2006, 2(3):408-409.
• [17]Bessler M, Daud A, Kim T, DiGiorgi M: Prospective randomized trial of banded versus nonbanded gastric bypass for the super obese: early results. Surg Obes Relat Dis 2007, 3(4):480-484.
• [18]Karcz WKBT, Marjanovic G, Kuesters S: To have or not to have the ring: early and late surgical complications after banded Roux-en-Y gastric bypass. Videosurgery Miniinvasive Tech 2008, 3(2):53-65.
• [19]Nishie A, Brown B, Barloon T, Kuehn D, Samuel I: Comparison of size of proximal gastric pouch and short-term weight loss following routine upper gastrointestinal contrast study after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2007, 17(9):1183-1188.
• [20]MacArthur RI, Smith DE, Hermreck AS, Jewell WR, Hardin CA: Revision of gastric bypass. Am J Surg 1980, 140(6):751-754.
• [21]Mali J Jr, Fernandes FA, Valezi AC, Matsuo T, Menezes Mde A: Influence of the actual diameter of the gastric pouch outlet in weight loss after silicon ring Roux-en-Y gastric bypass: an endoscopic study. Obes Surg 2010, 20(9):1231-1235.
• [22]Fobi MA, Lee H, Felahy B, Che K, Ako P, Fobi N: Choosing an operation for weight control, and the transected banded gastric bypass. Obes Surg 2005, 15(1):114-121.
• [23]Salinas A, Santiago E, Yeguez J, Antor M, Salinas H: Silastic ring vertical gastric bypass: evolution of an open surgical technique, and review of 1,588 cases. Obes Surg 2005, 15(10):1403-1407.
• [24]Schwartz ML, Drew RL, Roiger RW, Ketover SR, Chazin-Caldie M: Stenosis of the gastroenterostomy after laparoscopic gastric bypass. Obes Surg 2004, 14(4):484-491.
• [25]Dillemans B, Van CS, Agrawal S, Van DE, Mulier JP: Laparoscopic adjustable banded roux-en-y gastric bypass as a primary procedure for the super-super-obese (body mass index >60 kg/m(2)). BMC Surg 2010, 10:33. BioMed Central Full Text
• [26]Bessler M, Daud A, DiGiorgi MF, Olivero-Rivera L, Davis D: Adjustable gastric banding as a revisional bariatric procedure after failed gastric bypass. Obes Surg 2005, 15(10):1443-1448.
• [27]Alexander JW, Martin Hawver LR, Goodman HR: Banded sleeve gastrectomy-initial experience. Obes Surg 2009, 19(11):1591-6.
• [28]Karcz WK, Marjanovic G, Grueneberger J, Baumann T, Bukhari W, Krawczykowski D, Kuesters S: Banded sleeve gastrectomy using the GaBP ring - surgical technique. Obes Facts 2011, 4(1):77-80.
• [29]Karcz WK, Karcz-Socha I, Marjanovic G, Kuesters S, Goos M, Hopt UT, Szewczyk T, Baumann T, Grueneberger JM: To band or not to band–early results of banded sleeve gastrectomy. Obes Surg 2014, 24(4):660-665.
• [30]Fobi MA, Lee H, Felahy B, Che-Senge K, Fields CB, Sanguinette MC: Fifty consecutive patients with the GaBP ring system used in the banded gastric bypass operation for obesity with follow up of at least 1 year. Surg Obes Relat Dis 2005, 1(6):569-572.
• [31]Valezi AC, Mali JJ, de Menezes MA, de Brito EM, de Souza SA: Weight loss outcome after silastic ring Roux-en-Y gastric bypass: 8 years of follow-up. Obes Surg 2010, 20(11):1491-1495.
• [32]Salinas A, Salinas HM, Santiago E, Garcia W, Ferro Q, Antor M: Silastic ring vertical gastric bypass: cohort study with 83% rate of 5-year follow-up. Surg Obes Relat Dis 2009, 5(4):455-458.
• [33]White S, Brooks E, Jurikova L, Stubbs RS: Long-term outcomes after gastric bypass. Obes Surg 2005, 15(2):155-163.
• [34]Arceo-Olaiz R, Espana-Gomez MN, Montalvo-Hernandez J, Velazquez-Fernandez D, Pantoja JP, Herrera MF: Maximal weight loss after banded and unbanded laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial. Surg Obes Relat Dis 2008, 4(4):507-511.
• [35]O’Brien PE, McPhail T, Chaston TB, Dixon JB: Systematic review of medium-term weight loss after bariatric operations. Obes Surg 2006, 16(8):1032-1040.
• [36]Fobi M, Lee H, Igwe D, Felahy B, James E, Stanczyk M, Fobi N: Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Obes Surg 2001, 11(6):699-707.
• [37]Swain JM, Scott P, Nesset E, Sarr MG: All strictures are not alike: laparoscopic removal of nonadjustable Silastic bands after banded Roux-en-Y gastric bypass. Surg Obes Relat Dis 2010, 8(2):190-3.
• [38]Taddeucci RJ, Madan AK, Ternovits CA, Tichansky DS: Laparoscopic re-operations for band removal after open banded gastric bypass. Obes Surg 2007, 17(1):35-38.
• [39]Padoin AV, Galvao NM, Moretto M, Barancelli F, Schroer CE, Mottin CC: Obese patients with type 2 diabetes submitted to banded gastric bypass: greater incidence of dumping syndrome. Obes Surg 2009, 19(11):1481-1484.