Long-Term Outcomes of the Laparoscopic Adjustable Gastric Banding: Weight Loss and Removal Rate. A Single Center Experience on 301 Patients with a Minimum Follow-Up of 10years.

Abstract

Obesity is a chronic disease that requires procedures to enable to maintain good long-term results. Laparoscopic adjustable gastric banding (LAGB) studies with a long-term follow-up are limited and have often given conflicting results. We report our results in terms of banding life span and weight loss in a cohort of 301 patients operated on LAGB with a minimum follow-up of 10years. All patients who underwent LAGB at our university hospital between 1998 and 2004 were included in this study. The main outcome was band survival and complications that led to band removal, and the secondary outcome was weight loss. We present raw data and data after imputation for patients lost at follow-up. Most patients were women (83%), and the mean body mass index (BMI) baseline was 45.2±6.7. The pars flaccida technique was performed in 50.9% of the patients. All patients had at least 10years of follow-up (range 10-16years). Data were available at 10years for 79.7% and at 15years for 80.6%. Band survival was 65.8% at 10years and 53.3% at 15years. Mean excess weight loss (EWL) at 5, 10, and 15years was 41.4, 38.7, and 35.1%, respectively. Despite the encouraging short-term results, LAGB shows long-term disappointing results in terms of weight loss and complication rates. The removal rate increases with time (about 3-4% per year), and at 15years, almost half of the bands had been removed.