Safety Of Adjustable Gastric Banding Research Articles

Effectiveness and Safety of Adjustable Gastric Banding in Morbidly Obese Patients After 5 Years of Follow-up

Abstract Obesity is a civilization disease that promotes the emergence and development of many diseases, such as type II diabetes, cardiovascular, and some cancers. It directly affects the length and quality of life. The purpose of this retrospective study was to show the short- and long-term results of weight loss after laparoscopic adjustable gastric banding (LAGB) as well as to assess the results of the procedure and the percentage of reoperations. Case series analysis included 228 subsequent patients who underwent LAGB due to obesity. In the postoperative period, there was a gradual reduction in body weight, especially in the first 24 months after surgery. After 3 years, no further weight reduction was observed, and sometimes, a slight increase in weight was observed 5 years after surgery; the trend in weight reduction over the entire time period was significant. A similar result was found for percentage of BMI loss (%BMIL) and percentage of excess body weight loss (%EWL), especially in the first 36 months after surgery. Our study confirmed the good early results and low effectiveness of laparoscopic adjustable gastric banding in the long-term treatment of pathological obesity. On the other hand, the simplicity and safety of the procedure, the minimal effects of malnutrition, the low number of early complications, and the total reversibility or conversion procedure for any other bariatric surgery are the strengths of laparoscopic adjustable gastric banding for a selected group of patients.

Results and Complications after Laparoscopic Adjustable Gastric Banding in Super-obese Patients, using the Swedish Band

Laparoscopic adjustable gastric banding is effective in inducing weight loss, as well as being minimally invasive, totally reversible, and adjustable to the patient's needs. The aim of this study was to assess the efficacy and safety of adjustable gastric banding with the Swedish band (SAGB) in super-obese patients. Between January 1996 and December 2003, 682 patients (570 women, 112 men) underwent SABG implantation. In these patients, there were 60 super-obese patients with a BMI >/= 50 kg/m(2). Two groups of patients were analyzed: Group 50 (n = 30 patients) with a BMI 50-54 kg/m(2) and Group 55 (n = 30 patients) with a BMI >/= 55 kg/m(2). 13 different surgeons (9 general and 4 bariatric surgeons) performed the SAGB. All data (demographic and morphologic data, operative data, and follow-up data) were prospectively collected in a computerized data bank. 60 patients (8.8%) out of 682 were super-obese and entered the study. Mean %EWL was 39.2 at 1 year and 60.4 at 4 years, BMI fell from 55.5 to 34.7 at 4 years. The complication rate was 26.7% (16/60). General surgeons 12/60 (20%) had more complications than bariatric surgeons 4/60 (6.7%). In Group 50, mean %EWL was 42.1 at 1 year, 55.9 at 2 years, 61.5 at 3 years and 59.9 at 4 years. BMI fell from 51.8 to 33.2 at 4 years. Postoperative complications occurred in 6/30 patients (20%): pouch dilatation (n=2), band migration (n=2) and band leakage (n=2). In Group 55, mean %EWL was 36.8 at 1 year, 55.3 at 2 years, 55.8 at 3 years, and 59.4 at 4 years. BMI fell from 59.1 to 36.4 at 4 years. Postoperative complications occurred in 10/30 patients (33.3%): pouch dilatation (n=2), band migration (n=3) and band leakage (n=5). There was no mortality. SAGB is an effective procedure for the surgical treatment of super-obesity. Because of the high complication rate, super-obese patients should only be treated by experienced bariatric surgeons.