Prospective Evaluation and 7-Year Follow-up of Swedish Adjustable Gastric Banding in Adults with Extreme Obesity

Abstract

BackgroundSwedish adjustable gastric banding (SAGB) is a widespread laparoscopic procedure in bariatric surgery. Few long-term data is available. AimTo determine long-term outcome after SAGB in 196 patients studied prospectively. Patients and Methods196 patients, 40 men, and 156 women have been operated from 1996 to 2005. Age was 38 ± 1 (mean ± sem) years. Mean follow-up was 63 ± 2 months. ResultsHospital morbidity was 3% (0.5% early reoperation); mortality was 0. Late complications were band migration (1%), leakage (5%), slipping (4%), or pouch dilatation (8%). Minor reoperations (tube replacement, port-related, and hernias) were needed in 7.5%. Cumulative major reoperation rate reached 32%. Eighteen percent had a band replacement; 14% had removal of band anatomy. Late mortality was 0.5%. Exactly 7 years after SAGB, BMI decreased from 45 ± 1 kg/m2 to 33 ± 1 kg/m2, and excess weight loss (EWL) was 61 ± 4%. Sixty-eight percent of the patients reached ≥50% EWL. ConclusionIn 14% of the patients, the band anatomy had to be removed. Seven years of intact band anatomy leads to a successful EWL of 61 ± 4% and to EWL of ≥50% in 68%. However, cumulative major reoperation rate of 32% in 7 years makes it mandatory to offer and discuss other bariatric procedures to the respective patients.