Laparoscopic gastric banding in older patients

Abstract

Hypothesis: Older patients experience the same benefits from a laparoscopic gastric banding (LGB) operation as younger patients.

Design: A case series of 320 morbidly obese and superobese patients who underwent LGB within a 46-month period.

Setting: University Hospital Innsbruck, General Surgical Department, Innsbruck, Austria.

Patients: A consecutive sample of 320 patients who met the criteria for a bariatric procedure and were aged 18 years or older. Patients were divided into the following 2 age groups: younger patients (group A, 18-49 years) and older patients (group B, > or =50 years).

Intervention: Laparoscopic gastric banding with an adjustable gastric band.

Main outcome measures: Clinicopathologic features, including weight loss, complications, length of hospital stay, and operative times, were reviewed retrospectively, and a multivariate analysis was carried out.

Results: Of 320 patients, we identified 68 older patients (21.5%, group B). The mean postoperative follow-up period was 12 months (range, 6-28 months). The average preoperative weight was 127.8 kg (body mass index [calculated as weight in kilograms divided by the square of height in meters], 44.29). The average total weight loss was 4.3 kg per month for the first 3 months, reaching an average total of 31.0 kg after 1 year. The excess weight loss after 12 months was 68%. Complications requiring reoperation occurred in 10.3% of patients. Ninety-seven percent of the patients reported an improvement in their comorbid conditions.

Conclusions: Older patients receive the same benefits from LGB as younger patients, with an acceptable postoperative complication rate. Presently, our upper age limit is 70 years.