SALVAGE OF FAILED VERTICAL GASTROPLASTY BY THE ADDITION OF A DISTAL GASTRIC BYPASS

Thirty-one patients underwent conversion of failed vertical banded gastroplasty by the addition of a distal gastric bypass. At the time of surgery eight patients had the gastroplasty stoma debanded, six with very small stomas and chronic dysphagia and two because the bands were eroded. In five additional patients staple-line breakdown was repaired. Thus, three groups were followed up: (1) debanded, (2) staple-line repaired, and (3) those with unmodified stomas. Mean follow-up post-conversion ranged from 3.5 to 5 years for all groups, some patients being followed for as long as 8 years. Weight loss data were analysed for the three separate groups. Mean percentage greatest excess weight loss was 73% for the main follow-up group and debanded patients and 85.4% for those having staple-line repair. The results indicate that while weight loss was satisfactory across all groups, the greatest and best maintained weight loss occurred in patients with intact or reconstructed staple-lines and with stomas near 10 mm in diameter.