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

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. 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. 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. 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.