Long-term outcomes of laparoscopic adjustable gastric banding

January 01, 0001

Long-term outcomes of laparoscopic adjustable gastric banding

These Belgian investigators sought to determine the long-term efficacy and safety of laparoscopic adjustable gastric banding (LAGB) for morbid obesity. Their cohort was a total of 151 consecutive patients who had benefited from LAGB between January 1994, and December 1997 assessed at least 12 years after the initial procedure.

They found: "The median age of patients was 50 years (range, 28-73 years). The operative mortality rate was zero. Overall, the rate of follow-up was 54.3% (82 of 151 patients). The long-term mortality rate from unrelated causes was 3.7%. Twenty-two percent of patients experienced minor complications, and 39% experienced major complications (28% experienced band erosion). Seventeen percent of patients had their procedure switched to laparoscopic Roux-en-Y gastric bypass. Overall, the (intention-to-treat) mean excess weight loss was 42.8% (range, 24%-143%). Thirty-six patients (51.4%) still had their band, and their mean excess weight loss was 48% (range, 38%- 58%). Overall, the satisfaction index was good for 60.3% of patients. The quality-of-life score (using the Bariatric Analysis and Reporting Outcome System) was neutral."

The authors concluded: "Based on a follow-up of 54.3% of patients, LAGB appears to result in a mean excess weight loss of 42.8% after 12 years or longer. Of 78 patients, 47 (60.3%) were satisfied, and the quality- of-life index was neutral. However, because nearly 1 out of 3 patients experienced band erosion, and nearly 50% of the patients required removal of their bands (contributing to a reoperation rate of 60%), LAGB appears to result in relatively poor long-term outcomes."

The results are even less positive if you consider that the large group of those who were lost to follow-up may have been less successful.

For the full abstract, click here.

Arch Surg 146(7):802-807, July 2011 © 2011 to the American Medical Association
Long-term Outcomes of Laparoscopic Adjustable Gastric Banding. Jacques Himpens, Guy-Bernard Cadière, Michel Bazi, Michael Vouche, Benjamin Cadière, Giovanni Dapri. Correspondence to Dr. Himpens: [email protected]

Category: D. Digestive. Keywords: obesity, bariatric surgery, laparoscopic adjustable, gastric banding, long-term outcomes, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 9 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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