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Band erosion in patients who have undergone vertical banded gastroplasty: incidence and technical solutions
1Department of General Surgery, University Hospital Germans Trias i Pujol, Barcelona, Spain.
Objectives:
To study the incidence of band erosion in patients who have undergone vertical banded gastroplasty and to describe the reparative techniques used.
Design:
A retrospective review case series.
Setting:
A university hospital-based tertiary referral center.
Patients:
Two hundred fifty consecutive morbidly obese patients who underwent vertical banded gastroplasty between 1987 and 1995.
Main Outcome Measures:
The development of band erosion into the stomach, reparative surgical techniques, and long-term weight loss control.
Results:
Band erosion developed in 7 (2.8%) of the patients. Two patients had symptoms 1 month after undergoing forced endoscopy. Six patients required reoperation. The operative findings included 2 cases of "external" band erosion through the lesser curvature into the stomach and 4 cases of "internal" band erosion through the circular staple line. The surgical techniques used for repair depended on the radiological and endoscopic data and on the operative findings; the techniques included conversion into a gastric bypass, band replacement after the creation of a new stoma, and gastroplasty plus distal gastric bypass. There were no complications, and adequate long-term weight loss was achieved in all but 1 of the patients who underwent reoperation.
Conclusion:
Band erosion may be corrected using appropriate surgical techniques to allow for adequate long-term weight loss in patients who have undergone vertical banded gastroplasty.