Long-Term Follow-Up of Gastric Banding 10 Years and Beyond

Abstract

Background: This investigation assessed the long-term outcome of patients with gastric banding implanted more than 10 years ago.

Methods: A total of 73 patients undergoing laparoscopic gastric banding between 1997 and 2003 were identified. Patients who had their band removed were converted to a laparoscopic gastric bypass procedure.

Results: The mean preoperative body mass index (BMI) was 44.4 (SD 5.3). The mean follow-up was 11.6 (SD 2.1) years. The reasons for reoperation were leakage (N = 16, 21.9 %), slipping (N = 15, 20.5 %), and insufficient weight loss (N = 9, 12.3 %). The band was left in situ in 33 patients (45.2 %). The 5- and 10-year survival rates for the banding were 82.2 % (95 %CI 73.9-91.5 %) and 53.4 % (95 %CI 43.1-66.2 %). Best results were observed in male patients (10-year survival rate 76.5 %, 95 %CI 58.7-99.5 %, HR = 0.44, P = 0.043) and patients older than 50 years (10-year survival rate 63.8 %, 95 %CI 51.5-79.2 %, HR = 0.41, P = 0.006). Overall, the BMI was 31.0 (SD 6.3) at follow-up, excess weight loss was 68.1 % (SD 26.4), and the score for the Moorehead-Ardelt Questionnaire was 1.6 (SD 1.0). Similar results were obtained for patients with and without banding failure.

Conclusion: The present investigation provides evidence that gastric banding remains effective after more than 10 years in less than 50 % of initially operated patients. Older (>50 years) and male patients seemed to maintain the banding as long-time carriers with good results, and these patients subjectively profited from this method. Good results can be achieved if patients are followed thoroughly, and alternative surgical options for patients who fail may be offered with longstanding success.

Keywords: Gastric banding; Laparoscopic proximal gastric bypass; Long-term band carriers; Long-term follow-up; Survival of laparoscopic gastric banding.