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. 2024 Jul;34(7):2411-2419.
doi: 10.1007/s11695-024-07353-8. Epub 2024 Jun 11.

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

Juan S Barajas-Gamboa  1 , Valentina Duran  2 , Gustavo Romero-Velez  3   4 , Valentin Mocanu  5 , Yung Lee  6 , Ricard Corcelles  3   4 , Matthew Allemang  3   4 , Andrew T Strong  3   4 , Salvador Navarrete  3   4 , John Rodriguez  1   4 , Matthew Kroh  3   4 , Jerry T Dang  7   8
Affiliations

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

Juan S Barajas-Gamboa et al. Obes Surg. 2024 Jul.

Abstract

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.

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

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Conflict of interest statement

1. Juan S. Barajas-Gamboa, MD: This author does not have conflict of interest.

2. Valentina Duran, MD: This author does not have conflict of interest.

3. Gustavo Romero-Velez, MD: This author does not have conflict of interest.

4. Valentin Mocanu, MD, PhD: This author does not have conflict of interest.

5. Yung Lee, MD, MPH: This author does not have conflict of interest.

6. Ricard Corcelles, MD, PhD: This author does not have conflict of interest.

7. Matthew Allemang, MD: This author does not have conflict of interest.

8. Andrew T. Strong, MD: This author does not have conflict of interest.

9. Salvador Navarrete, MD: This author does not have conflict of interest.

10. John Rodriguez, MD: This author does not have conflict of interest.

11. Matthew Kroh, MD: This author does not have conflict of interest.

12. Jerry T. Dang, MD, PhD: This author does not have conflict of interest.

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