Three-year results of Roux-en-Y gastric bypass-on-vertical banded gastroplasty: an effective and safe procedure which enables endoscopy and X-ray study of the stomach and biliary tract.

Background: Cancer, perforation and bleeding in the bypassed stomach after RYGBP are rare but serious complications that require early diagnosis. Our goal was to perform a Roux-en-Y gastric bypass (RYGBP) whereby the traditional endoscopic and x-ray study of the bypassed stomach was possible, and at the same time obtain a good weight loss, similar to the standard RYGBP. We developed the RYGBP-on-Vertical banded gastroplasty (RYGBP on VBG), where a Goretex band surrounds the gastro-gastric outlet.
Methods: From June 2002 to September 2005, 128 patients, 94 female and 34 male, with age 50.5 +/- 14.8 SD years, BMI 51.6 +/- 7.2 SD kg/m2, and %EW 117.9 +/- 33.5 SD underwent RYGBP on VBG via an open approach. Radiological and, if necessary, endoscopic study has been carried out at 6 months, 1 year and then annually postoperatively.
Results: Two cases of anastomotic ulcer were detected, but no case of infection of the prosthetic material was found. Preoperative BMI fell from 51.6 +/- 7.2 to 38.1 +/- 6.6 after 6 months, to 35.0 +/- 7.1 after 1 year, to 34.4 +/- 6.1 after 2 years, and to 33.2 +/- 5.5 after 3 years.
Conclusion: RYGBP on VBG was effective; the weight loss curve, compared to standard RYGBP, is similar, while allowing the traditional x-ray and endoscopy of the bypassed stomach and thus the biliary tract.