Combined Laparoscopic Gastric Banding and Stomach Reduction (GBSR): Initial Experience After 1 Year

Abstract

We combined laparoscopic adjustable gastric banding (LAGB) and laparoscopic partial gastrectomy into a single procedure (GBSR). The 6- and 12-month percent excess weight loss (EWL) was compared to results expected from the literature for LAGB and laparoscopic Roux-en-Y gastric bypass (LRYGB) using t test. The time to band adjustment was compared with the 6-week period experienced in our setting for LAGB using a sign test. Eighteen patients were considered. One patient had gastric leak and had the band removed in postoperative day 1. Seventeen patients were followed-up. The patients, 4 men and 13 women, had a mean age of 38.8 years, an initial mean BMI of 52.4 kg/m2, and a mean of 8.3 comorbidities. All required outpatient band adjustment, eight at 4 months, eight at 5 months, and one at 6 months; the median 5 months was greater than the 6 weeks expected for LAGB (P < 0.001). The mean 6-month EWL, 28.6%, was similar to that expected for LAGB (P = 0.24) and less than that expected for LYRGB (P < 0.001). The mean 12-month EWL, 57.4%, was greater than that expected for LAGB (P < 0.001) and less than that expected for LYRGB (P < 0.001). Although GBSR's EWL at 6 and 12 months is less than that of LRYGB, GBSR should be further studied and applied in specific situations only.