Application of laparoscopic adjustable gastric banding and a multi-disciplinary team approach in treatment of morbid obesity and its complications

Abstract

To assess the safety and feasibility of laparoscopic adjustable gastric banding (LAGB) and a multi-disciplinary team (MDT) approach in the treatment of morbid obesity and its complications. We retrospectively analyzed the clinical data of 16 patients who underwent LAGB and MDT approach in Peking Union Medical College Hospital from October 2009 to February 2011. Of these 16 patients, 15 patients completed the 3 month follow up; their body weight and body mass index (BMI) decreased significantly after treatment (both P=0.000), with an percentage of excess weight loss (%EWL) of (25.7±7.4)%. Thirteen patients completed 6 month follow up; their body weight and BMI were significantly lower than the preoperative levels (both P=0.001), while there were no significant difference between the third and sixth month measurements (P=0.103 and P=0.053, respectively); %EWL of 6 months after operation was significantly higher than that of 3 months after operation [(37.0±14.7)% vs. (29.1±6.8)%,P=0.042]. Six patients completed 12 month follow up; their body weight and BMI decreased significantly at the first 3 months after operation (P=0.007 and P=0.005,respectively) and at the second 6 postoperative months (P=0.007 and P=0.013,respectively); the BMI of 6 months after operation was significantly lower than that of 3 months after operation (P=0.045), but there was no significant difference of body weight between the third and sixth month after operation (P=0.065); meanwhile, the %EWL increased significantly within the second 3 postoperative months from (29.6±6.8é% to(42.4±14.0é%(P=0.028), and also within the second 6 postoperative months (60.4±12.6é%(P=0.001). In 9 patients with pre-operative obstructive sleep apnea hypopnea syndrome, the symptom was remarkably resolved in all these 9 patients 3 months after the treatment. Of 16 patients with preoperative metabolic syndrome, the condition was obviously improved after treatment in 10 patients. Of 9 patients with hypertension preoperatively, the blood pressure returned to normal level after the withdrawal of antihypertensive agents in 7 patients; in addition, one patient had his dose decreased and one patient switched to a milder antihypertensive agent. Of 8 patients accompanied with type 2 diabetes, 7 had their antidiabetic drugs withdrawn after the blood sugar returned normal and one patient had his dose decreased. LAGB combined with MDT approach is effective, safe, and feasible for treating morbid obesity and its complications.