Objective:
Evaluate 5 years outcomes of banded gastric bypass as a primary and revisional bariatric procedure.
Methods:
A retrospective review of all banded gastric bypass between January 2011- March 2013. Outcomes included % Excess Weight loss(%EWL), weight loss maintenance and band related complications.
Results
142 patients underwent banded gastric bypass; 106 primary and 36 revisions. Indication for revisional procedures 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 44.8 kg/m2 (±6.9 kg/m2). After one, two, three, four and five years, %EWL was 81.9%(n=95)-81.1(n=82)-80.6%(n=70)-79.4(n=62)-74.9%(n=64).
In revisional procedures due to insufficient WL and weight regain; mean BMI was 40.8 kg/m2 (±6.01 kg/m2). One patient gained more weight and 16 patients had mean %EWL 69.7%(n=13)-76%(n=11)-71.6%(n=8)-62.7%(n=8)-52. 4%(n=10) after one, two, three, four and five years respectively.
In revision secondary to complications (n=19), mean preoperative BMI 28.4 kg/m2 (±3.5 kg/m2); The mean BMI was 28.06 kg/m2(n=15), 29.02 kg/m2(n=10), 29.8 kg/m2(n=9), 30.6 kg/m2(n=10) and 30.9 kg/m2(n=12) after 1,2,3,4 and 5 years respectively.
Band related complications after five years of follow up; erosion(n=2 - one with concomitant gastrogastric fistula), persistent dysphagia (band diameter 6.5cm(n=4) and 7.5cm (n=1)). One band was replaced 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).
Conclusion
Banded gastric bypass has impressive results in terms of weight loss and weight loss maintenance in both primary and revisional bariatric procedures with acceptable incidence of band related complications.