The MGB, almost 10 Years Later; A Study in Excellence

The MGB, almost 10 Years Later; A Study in Excellence

Safe, durable weight loss surgery, maybe the best possible weight loss surgery.

Over 9 years later revisions in less than2.7%!

make mine MGB.

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Revisional surgery for laparoscopic minigastric bypass

Wei-Jei Lee, M.D., Ph.D. Affiliations Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taipei, Taiwan Correspondence: Wei-Jei Lee, M.D., Ph.D., Department of Surgery, Min-Sheng General Hospital, National Taiwan University, 168 Chin Kuo Road, Tauoyan, Taiwan , Yi-Chih Lee, Ph.D. Affiliations Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taipei, Taiwan Department of International Business, Ching-Yun University, Jhongli City, Taiwan , Kong-Han Ser, M.D. Affiliations Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taipei, Taiwan , Shu-Chun Chen, R.N. Affiliations Department of Nursing, Min-Sheng General Hospital, Taoyuan, Taiwan , Jung-Chien Chen, M.D. Affiliations Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taipei, Taiwan , Yen-How Su, M.D. Affiliations Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taipei, Taiwan

Received 9 June 2010; accepted 25 October 2010. published online 01 November 2010.

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. Read more at www.soard.org

 

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