Ten years experience with laparoscopic adjustable gastric banding

Abstract

Background: Gastric banding is a safe and efficient bariatric procedure. We report here the results of 591 consecutive gastric bandings in terms of excess weight loss with up to 10 years follow-up and the complications.

Methods: Between June 1996 and September 2006, 591 patients underwent laparoscopic adjustable gastric banding (LAGB) by the same surgeon (JB). Of these patients, 69.2% were women. Mean age was 33.6 years +/- 10.7 and mean BMI was 41.95 kg/m2 +/- 8.7. Patients were reviewed monthly for the first 6 months, every 2 months for the next 6 months, and yearly thereafter. Excess weight loss was calculated at 6 months and 1, 2, 4, 6, 8, and 10 years.

Results: Six hundred eleven bands were implanted in 591 patients. Fifty-one patients (8.6%) had band removal due to a complication. Mean follow-up was 35 +/- 2 months. Percentage of excess weight loss was 45.8% +/- 27.4 at 6 months, 66.7% +/- 30.3 at 1 year, 72.6% +/- 28.8 at 2 years, 75.9% +/- 27.4 at 4 years, 82.8% +/- 32.6 at 6 years, 82.3% +/- 25.1 at 8 years, and 82.7% +/- 4.2 at 10 years. Complications encountered were band failure (9.3%), slippage (5.3%), erosion (4.6%), infection (2.4%), high band position (1.9%), and others (2.8%). Complication rate was 23.3% overall but dropped to 2.5% when calculated on the second half of the patients.

Conclusion: LAGB is a safe and efficient bariatric procedure. With experience, the complication rate drops to a very low level. Close follow-up can further increase its efficacy.