Prevalence, Indications, and Complications of Conversional Surgery After Vertical Banded Gastroplasty: A MBSAQIP Analysis.

Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 9106714 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1708-0428 (Electronic) Linking ISSN: 09608923 NLM ISO Abbreviation: Obes Surg Subsets: MEDLINE

Publication: 2006- : New York : Springer Science + Business Media
Original Publication: Oxford, OX, UK : Rapid Communications of Oxford, [1991-

Gastroplasty*/adverse effects ; Gastroplasty*/methods ; Obesity, Morbid*/surgery ; Postoperative Complications*/epidemiology ; Reoperation*/statistics & numerical data; Humans ; Retrospective Studies ; Female ; Male ; Prevalence ; Adult ; Middle Aged ; Gastric Bypass/adverse effects ; Gastric Bypass/statistics & numerical data ; Gastrectomy/adverse effects ; Gastrectomy/statistics & numerical data ; Conversion to Open Surgery/statistics & numerical data

Purpose: Vertical banded gastroplasty (VBG) was once the most popular bariatric procedure in the 1980's, with many patients subsequently requiring conversional surgery. However, knowledge regarding the prevalence and outcomes of these procedures remains limited. This study aims to determine the prevalence, indications, rate of 30-day serious complications, and mortality of conversional surgery after VBG.
Materials and Methods: A retrospective analysis of the MBSAQIP database from 2020 to 2022 was conducted. Individuals undergoing conversional or revisional surgery after VBG were included. The primary outcomes were 30-day serious complications and mortality.
Results: Of 716 VBG conversions, the common procedures included 660 (92.1%) Roux-en-Y gastric bypass (RYGB) and 56 (7.9%) sleeve gastrectomy (SG). The main indication for conversion was weight gain for RYGB (31.0%) and for SG (41.0%). RYGB had longer operative times than SG (223.7 vs 130.5 min, p < 0.001). Although not statistically significant, serious complications were higher after RYGB (14.7% vs 8.9%, p = 0.2). Leak rates were higher after SG (5.4 vs 3.5%) but this was not statistically significant (p = 0.4). Mortality was similar between RYGB and SG (1.2 vs 1.8%, p = 0.7). Multivariable regression showed higher body mass index, longer operative time, previous cardiac surgery and black race were independently associated with serious complications. Conversion to RYGB was not predictive of serious complications compared to SG (OR 0.96, 95%CI 0.34-2.67, p = 0.9).
Conclusions: Conversional surgery after VBG is uncommon, and the rate of complications and mortality remains high. Patients should be thoroughly evaluated and informed about these risks before undergoing conversion from VBG.
(© 2024. The Author(s).)

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Keywords: Conversional surgery; MBSAQIP; Revisional surgery; Vertical banded gastroplasty

Date Created: 20240610 Date Completed: 20240701 Latest Revision: 20240826

20240826

PMC11217115

10.1007/s11695-024-07353-8

38858296