AN OUTLET FOR ENDOSCOPIC ACCESS TO THE REMNANT DOES NOT REDUCE THE EFFECTIVENESS OF GASTRIC BYPASS: LONG-TERM OUTCOMES OF ROUX-EN-Y GASTRIC BYPASS ON VERTICAL BANDED GASTROPLASTY (RYGB-ON-VBG)

BACKGROUND: The Roux-en-Y Gastric Bypass on Vertical Banded Gastroplasty (RYGB-on-VBG) technique differs from traditional Gastric Bypass by leaving a small communication between gastric pouch and gastric remnant. The operation demonstred good results in the short-term, allowing the traditional endoscopy of the bypassed stomach. Aim of our study is to verify the outcomes in the long-term. METHODS: Between June 2002 and June 2009, 285 patients, with mean age 42.2 ± 11.9 years, mean BMI 48.0 ± 8.5 kg/m2 and mean EBW% xx underwent RYGB-on-VBG via an open approach. 38.2% of the patients were superobese. Preoperative comorbidities were hypertension (p. 143, 50.1%), OSAS (p. 71, 24.9%) and type II DM (p. 58, 20.3%). RESULTS: At 2 year of follow-up mean BMI and EWL% were 31.0±5.3 and 68.2±16.9 respectively. At 7 year of follow-up, where at the baseline 64% of the patients were superobese, the mean BMI and EWL% were 34.5±7.5 and 61.4±19.8 respectively. The average percentages of comorbidities resolution were: OSAS 90.1%; type II DM 83.5%; hypertension 47.5%; hyperlipidemia 30%. Early surgical complications were 4 (1.4%) and late were 5 (1.7%). CONCLUSIONS: Even in the long-term, the RYGB-on-VBG outcomes in term of weight loss, resolution of comorbidities and surgical complications are comparable to those after standard RYGB as reported in literature. In the follow-up, the RYGB-on-VBG also enables traditional diagnostic evaluation of the gastric remnant, which is only functionally excluded.