Long-term outcomes of gastric banding: Experience of a single tertiary care center specialized in bariatric surgery

Abstract

BackgroundLaparoscopic adjustable gastric banding (LAGB) was one of the first performed bariatric procedure performed in Europe in the 2000s with low postoperative morbidity and mortality. Our goal was to determine long term outcomes of LAGB. Methods138 consecutive patients underwent a LAGB between 2007 and 2019. Demographic data were recorded. Weight loss evolution over time, gastric band removal and revisional procedures were analyzed. Weigth loss success was defined at the end of the follow-up according to Reinhold’s criteria: BMI ≤ 35 and / or EBL% ≥50 %. Results125 patients were analyzed. Initial body weight was 121,9 kg (SD +/- 22,2) and initial body mass index (BMI) was 44 kg/m2 (SD+/- 6,5). Age at the first surgery (gastric banding) was 32,7 years (SD +/- 11,9). 45.6 % of all the patients had a successful outcome according to Reinhold's criteria with a median follow-up of 75,6 months (SD+/- 50,3). Mean excess weight loss was 40,4 (SD+/- 36,6) at last follow-up.54 patients (43,2 %) underwent band removal in a mean time of 54,2 months (SD+/- 35,8): 37 patients (29,6 %) had a second bariatric procedure. Success rate was 50 % after conversion. In univariate analysis, factors implicated with weight loss success at the last visit were success at 6 months, 1 and 2 years, the number of band tightening, lower initial BMI and better follow up. ConclusionThe factors significantly associated with LAGB success were early weight loss, better follow-up, a band not too tightened whereas high initial BMI was associated to failure.