Vertical banded gastroplasty in the treatment of morbid obesity: results of three year follow up.

Vertical banded gastroplasty has replaced jejunoileal bypass in the surgical treatment of morbid obesity. Although this procedure carries a low incidence of early postoperative complications there is little information on either longer term follow up or the impact on nutritional status. The present study describes the outcome in 42 patients with morbid obesity who underwent vertical banded gastroplasty and were followed up in a special nutrition clinic between nine and 36 months postoperatively. Body mass index (BMI) fell from a preoperative value of 47.4 (6.7) kg/m2 (mean (SD] to 37.5 (5.8), 35 (6.2), 33.9 (6.1), and 33.1 (5.7) kg/m2 at 6, 12, 24, and 36 months respectively. Immediate postoperative complications were minimal but during follow up four patients developed stenosis of the gastroplasty stoma and required reoperation. Plasma albumen concentrations were maintained but three patients developed iron deficiency anaemia. Most patients were able to eat a normal diet in reduced quantities and noted a marked improvement in the quality of life. The benefits and safety of vertical banded gastroplasty suggest an important role for this operation in the management of morbid obesity.