Staple Disruption in Vertical Banded Gastroplasty

Background: In earlier studies of vertical banded gastroplasty (VBG), staple-line disruptions (SD) were only reported in a few per cent or less. Two recent studies have shown a significantly higher frequency of SD. To find the true frequency of SD, all patients must be examined regardless of weight outcome.

Methods: 91 consecutive patients were examined by a standardized radiological method at different postoperative intervals ranging from 6 to 48 months.

Results: 41 out of 91 patients developed SD. The average diameter of the disruptions was 6 mm (range 2-16 mm). During the first 2 years of follow-up, when at least 31% of the patients had developed SD, there was no significant difference in weight loss between the group with SD and the group without SD.

Conclusion: SD is an inherent problem of VBG which has been underestimated for a long period of time. An SD frequency of 45% or more within the first few years is not acceptable and changes in the VBG technique must be considered.