Vertical banded gastroplasty-gastric bypass with and without the interposition of jejunum: Preliminary report

Background: The complications of the gastric pouch in gastric bypass surger y are well known. Since the first report of this surgery 30 years ago, new technical aspects that make it safer and more effective have been implement ed. Methods: As a modification of gastric bypass, the authors have performed 30 5 vertical banded gastroplasty-gastric bypass procedures. Two groups of pat ients underwent the procedure: Group I (n = 206) without a limb of jejunum interposed between the gastric pouch and the excluded stomach, and Group ii (n = 99) with a limb of jejunum interposed between the pouch and the stoma ch. The results regarding excess weight loss and complications of the gastr ic pouch during the first year after surgery were compared. Results: Age, sex, initial weight, body mass index, and percentage of ideal weight were similar in both groups. Excess weight loss was also similar. T he complications in Group I were 1 leak, 3 left subphrenic abscesses, 2 ero sive gastritis with bleeding, 1 stenosis of the gastrojejunostomy, 1 perfor ated ulcer, and 4 marginal ulcers with bleeding. Two patients in Group II d eveloped bleeding from the staple-line. Conclusions: These preliminary data suggest that complications of the gastr ic pouch can be reduced by interposing a limb of jejunum between the pouch and the excluded stomach. This is an early experience; long-term results ar e pending.