Low Revision Rates for the MGB, 9 Years Later!

Stunning new results of the MGB:

“Of the 1,322 patients, 23 (1.7%) had undergone revision surgery during a follow-up of 9 years.”

Amplify’d from www.sciencedirect.com
Surgery for Obesity and Related Diseases
Article in Press, Corrected ProofNote to users

Original article

Revisional surgery for laparoscopic minigastric bypass
Wei-Jei Lee M.D., Ph.D.a, Corresponding Author Contact Information, E-mail The Corresponding Author, Yi-Chih Lee Ph.D.a, c, Kong-Han Ser M.D.a, Shu-Chun Chen R.N.b, Jung-Chien Chen M.D.a and Yen-How Su M.D.a
Editorial comment
Surgery for Obesity and Related Diseases, In Press, Corrected Proof, Available online 10 December 2010,
Michel M. Murr

PDF (122 K)
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Abstract

Background:

Laparoscopic minigastric bypass (LMGB), a sleeved gastric tube with Billroth II anastomosis, has been proposed as an alternative to laparoscopic Roux-en-Y gastric bypass (LRYGB) for morbid obesity. However, the data regarding revision surgery after LMGB during long-term follow-up is not clear.

Methods:

From January 2001 to December 2009, 1322 patients (996 women and 326 men, mean age 31.6 ± 9.1 years, mean body mass index 40.2 ± 7.4 kg/m2), who were enrolled in a surgically supervised weight loss program and had undergone LMGB were included. All the patients received regular yearly follow-up, and all the clinical data were prospectively collected and stored. The reasons and type of surgery for revision surgery were identified and analyzed.

Results:

The excess weight loss and mean body mass index at 5 years after LMGB was 72.1% and 27.1 ± 4.6 kg/m2. Of the 1322 patients, 23 (1.7%) had undergone revision surgery during a follow-up of 9 years. The estimated accumulated revision rate of 9 years was 2.69% for LMGB. The most common cause of revision was malnutrition in 9 (39.1%), followed by inadequate weight loss in 8 (34.7%), and intractable bile reflux and dissatisfaction each in 3 (13.0%). The type of revision surgery was LRYGB in 11 (47.8%), sleeve gastrectomy in 10 (43.5%), and conversion to a normal anatomic state in 2 (8.6%). All the revision procedures were performed using a laparoscopic approach, without major complications. Two patients underwent repeat second revision surgery to duodenal switch and biliopancreatic diversion each in 1 patient. All patients had satisfactory results after revision surgery. No patients had undergone revision surgery for internal hernia or ileus during the follow-up period.

Conclusion:

LMGB resulted in significant and sustained weight loss with an acceptably low revision rate at long-term follow-up. Revision surgery after LMGB can be performed using a laparoscopic approach with a low risk.

Keywords: Morbid obesity; Laparoscopy; Minigastric bypass; Revision

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