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

Abstract

BackgroundThe 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.Methods183 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.ResultsMean 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.ConclusionBanded 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.

OAGB vs BGBP: A retrospective comparative study of a cohort of patients who had bariatric surgery in 2012 at one centre by a single surgeon

“…Resolution of hypertension, SA and dyslipidaemia was comparable in both groups. These outcomes are consistent with what has been reported in the literature …”

“…These outcomes are consistent with what has been reported in the literature. 12,17 The incidence of nutrient, haemoglobin, albumin and protein deficiencies were higher at all times of follow up in this study in the OAGB group compared to the BGBP group (Table 4). Both operations are prone to iron and B12 deficiencies because of bypass of the duodeno-jejunal axis.…”

“…To address this issue, the Roux‐en‐Y banded gastric bypass (BGBP) procedure was introduced by Fobi and has been documented to produce better and sustained weight loss compared to the non‐banded gastric bypass (Figure ). This better outcome comes at an acceptable cost of a low incidence of ring erosion, slippage and solid food intolerance in a small group of patients . The other shortcoming of the gastric bypass is the difficulty of performing the operation in patients with severe obesity.…”

“…This better outcome comes at an acceptable cost of a low incidence of ring erosion, slippage and solid food intolerance in a small group of patients. 12 The other shortcoming of the gastric bypass is the difficulty of performing the operation in patients with severe obesity. It has a steep learning curve and is associated with longer operating time and a relatively high perioperative morbidity.…”

Surgery in Patients with Super Obesity: Medium‐Term Follow‐Up Outcomes at a High‐Volume Center

“…Many factors are probably responsible for the poor outcome after SG, including initial BMI, changes in dietary habits, and sleeve dilation (28)(29)(30). For these reasons, some authors have described implantation of a band or ring around the proximal sleeve pouch to improve weight loss and maintenance as in the BRYGB procedure (31)(32)(33)(34)(35). In our study, the BSG group showed a significant difference compared with the rest reported %EBWL of 66.74% and %TBWL of 38.2% after BSG, which were significantly greater than those in the SG patients in their study.…”