Complication Of Adjustable Gastric Banding Research Articles

Can the Long-Term Complications of Adjustable Gastric Banding Be Overcome? Preliminary Results of Adding Gastric Plication in Patients with Impending Gastric Band Failure.

A small percentage of patients fitted with a gastric band still experience "failure." Here, the authors demonstrate the safety and feasibility of band preserving-laparoscopic gastric plication (BP-LGP), which was designed to improve weight loss and decrease gastric band adjustment frequency and thereby improve patient quality of life. All 6 patients involved in this study had a gastric band in place for more than 1 year; the median interval from gastric banding to BP-LGP was 31.7 months (range, 19.7-49.9 months). Five (83.3%) patients were female. Preoperative median body mass index (BMI) at gastric banding was 35.4 kg/m(2) (range, 31.9-43.9 kg/m(2)), median nadir BMI with the gastric band was 25.7 kg/m(2) (range, 20.9-31.0 kg/m(2)), and percentage excess BMI loss (%EBMIL) ranged from 24.3% to 123.6%. Indications for BP-LGP were as follows: chronic gastric prolapse in 2 patients (33.3%), pouch-esophageal dilatation in 3 (50.0%), and insufficient weight loss in 4 (66.6%), which included 2 patients with weight loss failure (%EBMIL of <30%). The 6 patients consecutively underwent surgery from May 2014 to January 2015. No conversion to open surgery was necessary, and no perioperative complication or mortality occurred. Mean operative time was 190 minutes. All patients showed weight loss after revision and showed resolution of troublesome signs and symptoms. Median follow-up after revision was 7.3 months (range, 5.7-10.1 months), median BMI at last follow-up was 27.6 kg/m(2) (range, 22.7-34.0 kg/m(2)), and median %EBMIL was 75.7% (range, 21.0%-103.6%). Median fill volume before revision was 6.1 mL (range, 2.7-11.0 mL), and median fill volume after revision was 0.3 mL (range, 0.0-5.3 mL). Three patients (50%) had an empty band at last follow-up. This novel method of bariatric revision (modified BP-LGP) might have a role as a salvage procedure in patients with impending gastric band failure.

Simultaneous Gastric and Duodenal Erosions due to Adjustable Gastric Banding for Morbid Obesity.

Erosion is an uncommon but feared late complication of adjustable gastric banding for morbid obesity. A high index of clinical suspicion is required, since symptoms are usually vague and nonspecific. Diagnosis is confirmed on upper gastrointestinal endoscopy and band removal is the mainstay of treatment, with band revision or conversion to other bariatric modalities at a later stage. Duodenal erosion is a much rarer complication, caused by the connection tubing of the band. We present our experience with a case of simultaneous gastric and duodenal erosions, managed by laparoscopic explantation of the band, primary suture repair of the duodenum, and omentopexy.

PL-116: Severe esophagitis and Barrett's esophagus as an important complication of adjustable gastric band

PL-116: Severe esophagitis and Barrett's esophagus as an important complication of adjustable gastric band

Treatment of chronic obstruction as late complication of adjustable gastric band

Laparoscopic adjustable gastric banding is growing in popularity in the United States. A rare late complication is obstruction at the level of the band, with concentric gastric pouch dilation. In our patient, endoscopy showed gastric pouch dilation with food impaction and a restricted outlet. We describe the combined endoscopic and laparoscopic approach for alleviation of chronic obstruction as a late complication of an adjustable gastric band. This combined approach included laparoscopic band removal and scar excision with intraoperative endoscopic dilation.

BARIATRIC SURGERY; RISK AND BENEFIT

Obese patients loss more weight with bariatric surgery than with medical weight loss treatment. The laparoscopic Roux-en-Y gastric bypass procedure results in more short term weight loss than laparoscopic adjustable gastric banding, but the latter has fewer postoperative complication and lower mortality rate; long term comparative data are currently lacking. The decision regarding which procedure to perform should be based on individual patient and surgeon factors. Early complications of gastric bypass surgery are bleeding, anastomotic leak, wound infection, thromboembolism, and anastomotic stricture. Longer term complication scan include marginal ulcers, bowel obstruction, gallstones, and nutritional deficiencies. Complication of adjustable gastric banding includes prolapsed and erosion. Patient typically loses more than 50% of their excess weight after bariatric surgery. Obesity related diseases markedly improve after bariatric surgery, reducing cardiovascular risk and improving life expectancy. Patient undergoing bariatric surgery must commit to a program of lifestyle changes, diet, vitamin supplementation, and follow-up.

Band Erosion and Passage, Causing Small Bowel Obstruction

A rare complication of adjustable gastric banding is reported. A 65-year-old man developed recurrent vomiting, epigastric pain, and small-bowel obstruction 13 months after laparoscopic adjustable gastric banding for morbid obesity. Investigation revealed that the band had migrated completely into the gastric lumen and had passed far down the jejunum. The band was still connected by the tubing to the port chamber. By laparoscopy, the band was cut at the stomach, and removed via a jejunotomy. Postoperative course was uneventful. Complete band migration requires early removal of the band.

Complications of Adjustable Gastric Banding, a Radiological Pictorial Review

The purpose of this article is to review the radiologic appearance of complications of the adjustable gastric band. Continuous progress in surgical technique of adjustable gastric banding and the increasing experience of surgeons have decreased the rate of complications. However, because different complications may have the same clinical presentation but require different treatment, to give a definitive diagnosis, the radiologist must be aware of the surgical procedures and possible sequelae.

Intra-abdominal Abscess in the Course of Intragastric Migration of an Adjustable Gastric Band: a Potentially Life-threatening Complication

Intragastric band migration is a potential complication of adjustable gastric banding. A 39-year-old morbidly obese female underwent laparoscopic adjustable gastric banding. After uneventful postoperative follow-up of 4 years, she had slow, steady failure of the restrictive effect, associated with regain of weight. Intragastric band migration was confirmed on GI series, and the patient was admitted to the hospital for revision. The patient presented no symptoms of acute abdomen. Intraoperatively, a huge intra-abdominal abscess was discovered in the epigastric area. The stomach with the band and tubing were involved in the inflammatory process. Labtobacillus acidofilus was found to be the causative organism. Removal of the gastric band with simultaneous resectional gastric bypass was performed. The recovery proceeded with no complications. Intragastric band migration can cause intra-abdominal abscess; thus, we believe that every case of band migration should be treated without delay to avoid further complications.