Effect Of Vertical Banded Gastroplasty Research Articles

Effect of vertical banded gastroplasty on the natural history of gastritis in patients with morbid obesity: a follow-up study.

Vertical banded gastroplasty is an accepted surgical treatment for morbid obesity. The aim of this study was to evaluate its effect on the natural history of gastritis, as the occurrence of gastritis and dysplasia have been reported after gastric bypass, another type of bariatric surgery. Thirty-four patients who underwent vertical banded gastroplasty between 1983 and 1987 were studied, and the follow-up varied from 1 to 47 months (mean 22 months). We found no increase of gastritis and intestinal metaplasia after surgery, and we did not observe any case of gastric dysplasia. Only one patient with pre- and postoperative specimens showed a deterioration in gastric histology after surgery, and this was of a minor degree. These initial results are encouraging for surgeons interested in the treatment of morbid obesity.

Effects of vertical-banded gastroplasty on bone and mineral metabolism in obese patients.

The surgical treatment of obesity can have adverse effects on bone, but there are few published data on the effects of vertical-banded gastroplasty. Serial measurements of bone mineral density at the lumbar spine and three upper femoral sites, using dual-energy X-ray absorptiometry, and also of biochemical indices of bone and mineral metabolism at intervals up to 2 years after operation were performed in 18 patients with morbid obesity who had vertical-banded gastroplasty. Bone mineral density measurements were also made in age- and sex-matched non-obese controls. Bone density before operation was significantly greater in the obese than in the controls (P < 0.02 at all sites). The obese patients lost weight rapidly after vertical-banded gastroplasty (mean weight loss 29 kg at 1 year, P < 0.001). This was accompanied by a measurable loss of bone density from the trochanter and Ward's triangle sites in the upper femur (P < 0.05), but not from the lumbar spine. Bone density values remained stable over 14 months in the controls. Hydroxyproline excretion increased significantly (P < 0.005), indicating an increase in bone resorption. Alkaline phosphatase levels decreased significantly (P < 0.001), but this probably represents the reversal of hepatic steatosis. There was no evidence of hyperparathyroidism or vitamin D deficiency. In conclusion, vertical-banded gastroplasty causes modest bone density loss from femoral sites, but not the lumbar spine. The difficulties of assessing bone density changes in the obese are discussed.

THE EFFECTS OF VERTICAL BANDED GASTROPLASTY FOR MORBID OBESITY

To evaluate the effects of vertical banded gastroplasty (VBG) for morbid obesity associated with various complications, the changes in their obesity indexes and complications following surgery were observed. Thirty-six patients with simple obesity have been treated with VBG in our institute for these six years. The obesity index, which was 213±27% preoperatively, decreased to 150±18% at 6 months, 142±19% at one year, 141±17% at 3 years or 141±9% at 5 years after surgery. Obesity-related complications were preoperatively noted in high frequencies, such as 86% for fatty liver, 78% for glucose intolerance, 72% for arthritis, 67% for hyperlipidemia, and 44% for hypertention. With a loss of excess weight, these figures decreased to 9% for fatty liver, 9% for glucose intolerance, and 9% for hyperlipidemia at 3 years after surgery. Surgical complications, which were minor and treatable, were seen in 8.3%.These results clearly demonstrate that the vertical banded gastroplasty is effective to reduce excess weight as well as complications of morbid obesity.