Complications after gastroplasty and gastric bypass as a primary operationand as a reoperation

Background: Since 1991 we performed vertical banded gastroplasty (VBG) as o ur surgical treatment of choice for morbid obesity in 680 patients, and sin ce 1996 we also performed Roux-en-Y gastric bypass (RYGB) in 36 patients, F or revisional surgery, the surgeons chose procedures based on their experie nce. Methods: We recorded early complications (0.6%) and late complications (8.5 %) after the primary operations, When staple-line disruption or stenosis of the banded stoma occurred after VBG, revisional surgery was performed with re-VBG or conversion to RYGBP. Some early complications needed emergency o peration for bleeding or gastric perforation. Results: Mortality was zero, Reoperation with re-VBG and RYGBP was effectiv e in all patients, but for many, a long stay in hospital was necessary beca use reoperation had a high rate of early and late complications, 33.8% and 21.8% respectively. Conclusion: The treatment of complications after VBG with re-VBG and RYGBP had danger, We believe that when VBG failure occurs, to avoid dangerous com plications again, we should perform a biliopancreatic diversion, which does not involve a gastric restriction.