Vaneerdeweg W, Hubens G, Van Gaal L, Eyskens E
Department of Surgery, University Hospital Antwerp (U.I.A.), Belgium.
Acta Chir Belg. 1994 Jul-Aug;94(4):203-6.
Although vertical banded gastroplasty is considered as a safe and efficient bariatric procedure, reoperation rates either because of failure, or the induction of unacceptable side effects are important. In this study we evaluated 54 obese subjects with a history of vertical banded gastroplasty. One patient (2%) died postoperatively due to pulmonary embolism. Seven patients (13%) underwent a reoperation. A new vertical banded gastroplasty because of dilatation of the pouch with weight regain resulted in a loss of 26% of the initial weight after 3 years (1 patient). The vertical staple line disrupted in 4 patients: restapling failed after 1.5 year (1 patient), conversion into a gastric bypass resulted in a loss of only 12% of the initial weight after 3 years (1 patient), conversion into a biliopancreatic diversion resulted in a loss of 43 and 32% of body weight after 18 and 6 months, respectively (2 patients). In 2 cases a Nissen fundoplication was performed with good result for reflux oesophagitis. Since regastroplasty was not entirely successful in our hands, we consider biliopancreatic diversion as the method of choice for failed vertical banded gastroplasty.
尽管垂直捆绑胃成形术被认为是一种安全有效的减肥手术，但因手术失败或引发不可接受的副作用而进行再次手术的比率很重要。在本研究中，我们评估了54例有垂直捆绑胃成形术病史的肥胖受试者。1例患者（2%）术后因肺栓塞死亡。7例患者（13%）接受了再次手术。1例患者因胃囊扩张伴体重反弹而再次行垂直捆绑胃成形术，3年后体重减轻了初始体重的26%。4例患者的垂直吻合钉线断裂：1例患者在1.5年后再次吻合失败，改行胃旁路手术后3年仅减轻了初始体重的12%；2例患者改行胆胰转流术，分别在18个月和6个月后体重减轻了43%和32%。2例患者因反流性食管炎行nissen胃底折叠术，效果良好。由于在我们手中再次胃成形术并不完全成功，我们认为胆胰转流术是失败的垂直捆绑胃成形术的首选方法。
