Ten and more years after vertical banded gastroplasty as primary operationfor morbid obesity

Long-term follow-up (>10 years) after vertical banded gastroplasty (VBG) is almost nonexistent. The aim of this study was to determine long-term outco me after VBG in a group of 71 patients studied prospectively. Seventy-one c onsecutive patients with morbid obesity (54 women and 17 men; mean age 40 y ears [range 22 to 71 years]) underwent VBG from 1985 to 1985) and were foll owed prospectively. Follow-up was obtained in 70 (99%) of the 71 patients. Weight (mean +/- standard error of the mean) preoperatively was 138 +/- 3 k g and decreased to 108 +/- 2 kg 10 or more years postoperatively. Body mass index decreased from 49 +/- 1 to 39 +/- 1. Only 14 (20%) of 70 patients lo st and maintained the loss of at least half uf their excess body weight wit h the VBG anatomy. Vomiting one or more times per week continues to occur i n 21% and heartburn ill 16%. Fourteen patients have undergone conversion fr om VBG to Roux-en-Y gastric bypass (11 patients) or other procedures (3 pat ients) because of a combination of inadequate weight loss in 13 patients, g astroesophageal reflux in five, and frequent vomiting in four. Only 26% of patients after VBG have maintained a weight loss of at least 50% of their e r;cess body weight; 17% underwent bariatric reoperation with good results. Thus VBG is not an effective, durable bariatric operation.