A 5-Year Experience with Laparoscopic Adjustable Gastric Banding—Focus on Outcomes, Complications, and Their Management

Abstract

Laparoscopic adjustable gastric banding (LAGB) remains the most popular surgical modality for obesity management in Europe. The aim of this publication is to present a 5-year experience in obesity treatment with LAGB operation with the assessment of outcomes, frequency of complications, and their management. Management of the band-related complications is crucial for continuous obesity treatments, despite the fact of initial failure, allowing further excess weight loss in patients with morbid obesity. One hundred sixty patients underwent the LAGB procedure with standard pars flaccida technique during the years2005-2009. A retrospective analysis of the data was performed; chi-squared test and Student's t test at the level of significance of p < 0.05 were used. Information on reoperations was gathered from hospital case notes. In the presented group, the mean body mass index (BMI) was 48.13kg/m(2) (33.46-83.04kg/m(2); standard deviation [SD] ±8.45). Of the patients, 36.2% had super morbid obesity with BMI >50kg/m(2). The mean observation period reached 549days (31-2,026days; SD ±390.1), with the mean number of control visits of 4.2 (1-12). The mean percentage of excess weight loss during the observation period was 34% (from -9.9% to 85.1%; SD ±20.6), with the mean body mass reduction of 24.4kg. Complications appeared in 30 patients (20.1%). Twenty-four patients (16.1%) required reoperation. There were no mortalities recorded. The mean operative time of 59min was relatively short. Morbidity and mortality rates were comparable to many published series. Failure or complications of LAGB did not stop the obesity treatment. Most of the band-related complications occurred late and could be provided for laparoscopically.