Abstract
Background: Laparoscopic adjustable gastric banding (LAGB) gained popularity in the early 2000s as a purely restrictive procedure with modest weight loss. The potential for complications requiring reoperation has since become evident. A retrospective review was performed to determine the incidence of long-term complications and predictive factors requiring surgical reintervention after LAGB.Methods: Institutional review board approval was obtained, and a retrospective review of 200 consecutive patients undergoing LAGB over a period of six years was conducted at a single institution with American Society of Metabolic and Bariatric Surgery Center of Excellence designation. Data were collected on patient characteristics, comorbid conditions and complications requiring reintervention. Statistical analysis was performed using SPSS Statistics software (IBM Corp., Armonk, NY).Results: Of the 200 patients, 176 (90.7%) were female with an average age of 53.6 years and preoperative body mass index (BMI) of 44.2 kg/m2. The average follow-up was 46 months. Complications occurred in 55 (28.4%) patients with band slippage/prolapse as the most common need for reoperation. Younger age, lack of comorbidities and diet/exercise compliance were associated with reintervention.Conclusions: LAGB has a high rate of reoperation secondary to complications associated with younger age. Alternative bariatric procedures may be more appropriate in these patients who have fewer comorbid conditions and are motivated to improve his or her health.
Highlights
The disease of obesity and its related comorbid conditions represent the most significant public health threat of our time [1]
Institutional review board (IRB) approval to conduct the study was obtained at a university affiliated tertiary care center with an American Society of Metabolic and Bariatric Surgery (ASMBS) Center of Excellence designation and subsequent Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) accreditation
Studies revealed short-term superiority with the Laparoscopic adjustable gastric banding (LAGB) in regards to weight reduction (43-78 %EWL at three years), remission of diabetes and other obesity-related comorbidities compared with medical therapy alone [13,14,15]
Summary
The disease of obesity and its related comorbid conditions represent the most significant public health threat of our time [1]. Over the past 18 years, it has been utilized as a purely restrictive procedure for the treatment of obesity with reasonable weight loss results [5,6,7]. With more indwelling LAGBs, the potential for long-term complications requiring surgical intervention has become evident [8,9,10,11,12]. Predictive factors of these complications and reoperative rates have not fully been determined in the American patient population. Laparoscopic adjustable gastric banding (LAGB) gained popularity in the early 2000s as a purely restrictive procedure with modest weight loss. A retrospective review was performed to determine the incidence of long-term complications and predictive factors requiring surgical reintervention after LAGB
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