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Abstract：
OBJECTIVE: Vertical banded gastroplasty (VBG) was once the most popular bariatric procedure in the 1980\'s, with many patients subsequently requiring conversional surgery. However, knowledge regarding the prevalence and outcomes of these procedures remains limited. This study aims to determine the prevalence, indications, rate of 30-day serious complications, and mortality of conversional surgery after VBG.
METHODS: A retrospective analysis of the MBSAQIP database from 2020 to 2022 was conducted. Individuals undergoing conversional or revisional surgery after VBG were included. The primary outcomes were 30-day serious complications and mortality.
RESULTS: Of 716 VBG conversions, the common procedures included 660 (92.1%) Roux-en-Y gastric bypass (RYGB) and 56 (7.9%) sleeve gastrectomy (SG). The main indication for conversion was weight gain for RYGB (31.0%) and for SG (41.0%). RYGB had longer operative times than SG (223.7 vs 130.5 min, p < 0.001). Although not statistically significant, serious complications were higher after RYGB (14.7% vs 8.9%, p = 0.2). Leak rates were higher after SG (5.4 vs 3.5%) but this was not statistically significant (p = 0.4). Mortality was similar between RYGB and SG (1.2 vs 1.8%, p = 0.7). Multivariable regression showed higher body mass index, longer operative time, previous cardiac surgery and black race were independently associated with serious complications. Conversion to RYGB was not predictive of serious complications compared to SG (OR 0.96, 95%CI 0.34-2.67, p = 0.9).
CONCLUSIONS: Conversional surgery after VBG is uncommon, and the rate of complications and mortality remains high. Patients should be thoroughly evaluated and informed about these risks before undergoing conversion from VBG.
METHODS: A retrospective analysis of the MBSAQIP database from 2020 to 2022 was conducted. Individuals undergoing conversional or revisional surgery after VBG were included. The primary outcomes were 30-day serious complications and mortality.
RESULTS: Of 716 VBG conversions, the common procedures included 660 (92.1%) Roux-en-Y gastric bypass (RYGB) and 56 (7.9%) sleeve gastrectomy (SG). The main indication for conversion was weight gain for RYGB (31.0%) and for SG (41.0%). RYGB had longer operative times than SG (223.7 vs 130.5 min, p < 0.001). Although not statistically significant, serious complications were higher after RYGB (14.7% vs 8.9%, p = 0.2). Leak rates were higher after SG (5.4 vs 3.5%) but this was not statistically significant (p = 0.4). Mortality was similar between RYGB and SG (1.2 vs 1.8%, p = 0.7). Multivariable regression showed higher body mass index, longer operative time, previous cardiac surgery and black race were independently associated with serious complications. Conversion to RYGB was not predictive of serious complications compared to SG (OR 0.96, 95%CI 0.34-2.67, p = 0.9).
CONCLUSIONS: Conversional surgery after VBG is uncommon, and the rate of complications and mortality remains high. Patients should be thoroughly evaluated and informed about these risks before undergoing conversion from VBG.
摘要：
目的：垂直带状胃成形术（VBG）曾经是1980年代最流行的减肥手术，许多患者随后需要进行转换手术。然而,关于这些手术的患病率和结果的知识仍然有限.这项研究旨在确定患病率，适应症,30天严重并发症的发生率，VBG后转阴手术的死亡率。
方法：对2020年至2022年的MBSAQIP数据库进行了回顾性分析。包括在VBG后接受转换或修正手术的个体。主要结果是30天严重并发症和死亡率。
结果：716个VBG转换，常见手术包括660例(92.1%)Roux-en-Y胃旁路术(RYGB)和56例(7.9%)袖状胃切除术(SG).转化的主要指标是RYGB(31.0%)和SG(41.0%)的体重增加。RYGB的手术时间比SG长（223.7vs130.5分钟，p<0.001)。虽然没有统计学意义，RYGB术后严重并发症发生率较高(14.7%vs8.9%,p=0.2)。SG后泄漏率较高（5.4vs3.5％），但这没有统计学意义（p=0.4）。RYGB和SG的死亡率相似(1.2%vs1.8%，p=0.7)。多元回归显示较高的体重指数，更长的手术时间，既往心脏手术和黑人种族与严重并发症独立相关.与SG相比，转换为RYGB并不能预测严重的并发症（OR0.96，95CI0.34-2.67，p=0.9）。
结论：VBG后的转换手术并不常见，并发症和死亡率仍然很高。在从VBG转换之前，应彻底评估并告知患者这些风险。
方法：对2020年至2022年的MBSAQIP数据库进行了回顾性分析。包括在VBG后接受转换或修正手术的个体。主要结果是30天严重并发症和死亡率。
结果：716个VBG转换，常见手术包括660例(92.1%)Roux-en-Y胃旁路术(RYGB)和56例(7.9%)袖状胃切除术(SG).转化的主要指标是RYGB(31.0%)和SG(41.0%)的体重增加。RYGB的手术时间比SG长（223.7vs130.5分钟，p<0.001)。虽然没有统计学意义，RYGB术后严重并发症发生率较高(14.7%vs8.9%,p=0.2)。SG后泄漏率较高（5.4vs3.5％），但这没有统计学意义（p=0.4）。RYGB和SG的死亡率相似(1.2%vs1.8%，p=0.7)。多元回归显示较高的体重指数，更长的手术时间，既往心脏手术和黑人种族与严重并发症独立相关.与SG相比，转换为RYGB并不能预测严重的并发症（OR0.96，95CI0.34-2.67，p=0.9）。
结论：VBG后的转换手术并不常见，并发症和死亡率仍然很高。在从VBG转换之前，应彻底评估并告知患者这些风险。
