Biliopankreatische Diversion mit Duodenal-Switch: Verfahren nach Bandversagen

Abstract

The late outcome and the results after gastricbanding are influenced by a high postoperative complicationrate. Laparoscopic gastric banding appeared promising duringthe first years after its introduction, but results worsenover time, despite improvements in the operative technique.Each year of follow-up adds 3-4% to the major complicationrate, which contributes to the total failure rate. We report hereour experience with redo-surgery after failed gastric banding.Patients and Methods: Between February 2004 and December2006 we performed biliopancreatic diversion with duodenalswitch (BPD-DS) in 8 patients after failed gastric banding. Themean time between primary operation of gastric banding andrevision to BPD-DS was 74 months. Results: In 6/8 patientswe performed the operation by laparoscopy. The band wasremoved in 6/8 patients during the same operation. Therewere no intra- and postoperative complications. The postoperativefollow-up time was 1-34 months. Conclusion: Revisionof failed gastric banding by BPD-DS is an feasible option inour opinion. The operation should only performed in centershaving experience with BPD-DS as a primary operation. Thereare only few data in literature showing a wide range withrespect to the complication rate. In our opinion, the kind ofredo-operation after failed gastric banding depends onindividual decision, intraoperative findings, and experiencesof the bariatric center.