Laparoscopic adjustable gastric banding (LAGB) with gastric plication: Short-term results and comparison with LAGB alone and sleeve gastrectomy

Abstract

BackgroundLaparoscopic adjustable gastric banding (LAGB) is the safest type of bariatric surgery but is less effective than other bariatric surgeries. Combining LAGB with gastric plication (LAGB-P) may increase weight loss compared to LAGB alone. MethodsIn this study, we report our short-term experience with this novel technique and compare the data for the first 42 consecutive patients with the data for LAGB alone and LSG. Forty-two morbidly obese patients underwent LAGB-P and were followed for 12 months. Operative complications, weight loss, and late complications were followed and compared with matched groups of LAGB alone and laparoscopic sleeve gastrectomy (LSG). The setting was a university hospital in Taiwan. ResultsThe study consisted of 42 patients, specifically 21 males and 21 females with an average age of 32.6 ± 9.7 years (range 18 to 58) and a mean body mass index of 40.7 ± 6.1 kg/m2 (range 31.5 to 56.4). The mean operation time was 141.9 ± 24.8 minutes (range 105 to 190), and the mean hospital stay was 2.3 ± 1.9 days. Two (4.8%) major complications were encountered and resolved by laparoscopic revision surgery. There was 1 (2.4%) major complication in the LSG group and none in the LAGB group. The operation time for LAGB-P was longer than for LAGB and LSG (75.6 ± 17.9 and 110.5 ± 22.3 minutes; P<.001). The mean body mass index of the LAGB-P group decreased from 40.7 to 29.4 kg/m2 at 1 year after surgery, with an excess weight loss of 62.6%. This result is similar to the 67.2% excess weight loss in the LSG group, but is higher than the 31.7% excess weight loss of the LAGB group. At follow-up, revision surgery was required in 2 (4.8%) patients in the LAGBP group, none (0%) in the LAGB group, and 1 (2.4%) in the LSG group. More patients in the LSG group still required proton pump inhibitor treatment at 1 year after surgery than the other 2 groups ConclusionBy combining LAGB with gastric plication, LAGB-P can augment the weight loss of LAGB and is similar to LSG but may increase risk.