Banded Gastric Bypass: Better Long-Term Results? A Cohort Study with Minimum 5-Year Follow-Up

Abstract

BackgroundWhile gastric bypass has been the treatment of choice for morbid obesity, insufficient weight loss and even weight regain has been observed in a sub-group of patients. Dilatation of the pouch, pouch outlet, and proximal alimentary limb have been suggested to cause weight regain on the long term. The banded gastric bypass surgery has been introduced to overcome this problem.MethodsFour hundred thirty-two patients (n = 254, non-banded/n = 178, banded-GaBP Ring™) were followed-up for 5 years. Patients were evaluated for weight loss, % excess weight loss (%EWL), weight regain and BMI.ResultsNo significant differences between groups in the first year following surgery were observed in terms of weight loss and %EWL. %EWL at 5 years was as follows: non-banded 65.2 ± 20.0 %; banded 74.0 ± 15.1 %. At 5 years, the banded group showed more weight loss (non-banded 35.4 ± 12.5; banded 43.9 ± 11.9 kg, P < 0.0001); weight regain was significantly higher in the non-banded group (P < 0.0001). Only minor complications were reported; no signs of ring migration or slippage were reported.ConclusionAlthough, following the first year after surgery, no differences in treatment groups were observed in terms of weight loss, 5 years following surgery, patients who received banded surgery maintained better weight loss and had less weight regain compared to the non-banded group. These results suggest that laparoscopic banded gastric bypass using a silastic ring was effective in maintaining weight loss on the long term, while the complication rate was low. The banded gastric bypass is regarded by us as the new gold standard.

OAGB vs BGBP: A retrospective comparative study of a cohort of patients who had bariatric surgery in 2012 at one centre by a single surgeon

“…This difference in weight loss was maintained in all follow-up visits starting at the 6-month interval ( Table 2 and Reports comparing OAGB to RYGB have reported at least equal or more %EBWL. 16,26 Similarly, the weight loss outcome in the BGBP group in this study is similar to what has been reported by Bessler et al and other authors 10,28,29 who have shown better and sustained weight loss outcomes after BGBP compared to RYGB.…”

Early Weight Loss Outcomes and Glucose Metabolism Parameters After Banded Versus Non-Banded One Anastomosis Gastric Bypass: A Prospective Randomized Trial

“…On the other hand, the incidence of food intolerance appears to be higher among individuals who underwent banded bypass. Nonetheless, the current reported results in the literature are mixed, with a number studies showing a significantly higher weight loss, and others demonstrating no advantages (8,9) . The impact of the placement of bands on the outcomes after OAGB remains not completely determined and, to date and according to our knowledge, two studies performed at the same centre and published by Clarke et al and Sheikh et al described this possibility; these authors reported significant weight loss and resolution of co-morbidities (10,11) .…”

Revision procedures in bariatric surgery

“…Обоснованность подобного способа решения проблемы опирается на результаты сравнительных клинических исследований отдаленных результатов шунтирования желудка с дополнительной установкой бандажа (нерегулируемого) и без него. Применение препятствующего дилатации «малого» желудка полимерного кольца позволяет достичь достоверно большей эффективности снижения и контроля избыточной массы тела в отдаленном периоде (10 и более лет после операции): 81,7 против 62,3 % [11,16].…”

“…Во время операции проводили его частичное заполнение. Регулировка бандажа осуществляется по тем же принципам, что и при первичной имплантации устройства [16].…”

“…Установка бандажа в качестве дополнения к желудочному шунтированию в варианте Roux-en-Y позволяет добиться регресса 80-100 % набранного избыточного веса. Возможными осложнениями подобной ревизионной процедуры являются инфицирование и миграция конструкции, аррозии и стеноз «малого» желудка, отмечающиеся приблизительно в 3 % случаев [16].…”