Department of Surgery, Clinical Science Center, University of Wisconsin, Madison, WI 53792, USA.
Obes Surg. 2011 Aug;21(8):1220-4. doi: 10.1007/s11695-011-0358-5.
Vertical-banded gastroplasty (VBG) was once a common bariatric procedure. It has fallen out of favor due to the emergence of the adjustable gastric band and late complications including band erosion and stenosis. Options for revision include conversion to a Roux-en-Y gastric bypass (RYGB) or VBG reversal via gastrogastrostomy. Patients undergoing revision of a previous VBG were identified. VBG reversal was performed laparoscopically. Conversion to RYGB was performed by both laparotomy and laparoscopy. Perioperative outcomes and long-term weight loss were evaluated. A total of 34 patients with a previous open VBG underwent revision over a nearly 8-year period (January 2003 to September 2010). Conversion to RYGB was performed in 25 (four laparoscopically) and VBG reversal in nine patients. Mean age for all patients was 56.3 years (range 36-70), and VBG had been performed 23 years previously (range 16-30). Patients to undergo VBG reversal were more likely to be male and less likely to be morbidly obese at the time of revision. Operative time and length of stay were shorter for laparoscopic procedures. Complication rates did not differ based on technique or procedure. Patients with a previous VBG may present with complications and obesity decades after the primary procedure. Revisional surgery can be accomplished laparoscopically. Following VBG reversal, most patients gain weight and many become morbidly obese again. Conversion to RYGB is associated with weight loss and resolution of morbid obesity in most patients. When feasible, laparoscopic conversion to RYGB may offer the best outcomes.
垂直带式胃成形术（VBG）曾经是一种常见的减肥手术。由于可调胃带的出现以及后期并发症（包括带侵蚀和狭窄），它已经不再流行。修复的选择包括转换为 Roux-en-Y 胃旁路术（RYGB）或通过胃胃吻合术进行 VBG 反转。确定了接受以前的 VBG 修复的患者。通过腹腔镜进行 VBG 反转。通过剖腹手术和腹腔镜手术进行 RYGB 转换。评估了围手术期结果和长期减肥效果。在将近 8 年的时间里（2003 年 1 月至 2010 年 9 月），共有 34 例先前接受过开放式 VBG 的患者接受了修复。在 25 例患者中（4 例腹腔镜）进行了 RYGB 转换，9 例患者进行了 VBG 反转。所有患者的平均年龄为 56.3 岁（范围 36-70 岁），VBG 手术在 23 年前进行（范围 16-30 岁）。接受 VBG 反转的患者更有可能是男性，并且在修复时不太可能患有病态肥胖症。腹腔镜手术的手术时间和住院时间更短。并发症发生率与技术或手术无关。以前进行过 VBG 的患者可能会在初次手术后几十年出现并发症和肥胖症。修复手术可以通过腹腔镜完成。在 VBG 反转后，大多数患者体重增加，许多患者再次出现病态肥胖。在大多数患者中，转换为 RYGB 与减肥和病态肥胖的解决有关。在可行的情况下，腹腔镜转换为 RYGB 可能会提供最佳结果。
