Evaluate 5 years outcomes of banded gastric bypass (BRYGB) as a primary and revisional bariatric procedure.
A retrospective review of all BRYGB between January 2011- March 2013. Outcomes included % Excess Weight loss(%EWL), weight loss maintenance and band related complications.
142 patients underwent BRYGB; 106 primary and 36 conversions. Indication for conversion to BRYGB were complications of the primary procedure (n= 19), insufficient weight loss (n=5) and weight regain (n=12). In the primary group, mean preoperative BMI was 44.8 kg/m2 (±6.9 kg/m2). After 1, 2, 3, 4 and 5 years, %EWL was 81.9% (n=95), 81.1 (n=82), 80.6% (n=70), 79.4 (n=62), 75.4% (n=75) respectively. Mean %TWL compared to pre-revision weight was 33.9% (n=95), 34.1%(n=82), 34.0% (n=70), 33.9% (62), 31.8% (n=75) after 1, 2, 3, 4 and 5 years respectively. In conversions for insufficient WL and or weight regain; mean preoperative BMI was 40.8 kg/m2 (±6.01 kg/m2). One patient gained weight
and 16 patients had mean %EWL 69.7%(n=13), 76%(n=11), 71.6%(n=8), 62.7%(n=8) and 52.4%(n=11) after one, two, three, four and five years respectively. Compared to pre-revision weight, % TWL was 25.7% (n=13), 28% (n=11), 23.9 (n=8), 18.3(n=8) and 18.2 (n=11) respectively.
In conversions secondary to complications of the primary procedure (n=19), mean preoperative BMI was 28.4 kg/m2 (±3.5 kg/m2); after 1,2,3,4 and 5 years mean BMI was 28.1 kg/m2(n=15), 29 kg/m2(n=10), 29.8 kg/m2(n=9), 30.6 kg/m2(n=10) and 30.9 kg/m2(n=12) respectively.
Band related complications after five years of follow up: erosion (n=3, one with concomitant gastro-gastric fistula), persistent dysphagia (band diameter 6.5cm (n=5). One band was repositioned as it was around the gastrojejunostomy. Perioperative surgical complications (30 days); bleeding(n=2), leakage and band removal(n=1), port site hernia(n=1), food impaction(n=1), wound problems(n=2).
Banded gastric bypass has good results in terms of weight loss and weight loss maintenance in both primary and revisional bariatric procedures with acceptable incidence of band related complications.