, Volume 19, Issue 12, pp 1657-1663
Date: 26 Aug 2009

Mortality After Laparoscopic Adjustable Gastric Banding: Results from an Anonymous Questionnaire to ASBS Members

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Abstract

Background

Laparoscopic adjustable gastric banding (LAGB) approved 6 years ago by the Federal Drug Administration is considered a safe and simple procedure for weight loss with a reported low mortality rate (0.05%) in the literature. The aim of the study was to probe the membership of the American Society for Bariatric Surgery (ASBS) to elucidate the incidence and possible causes of unreported operative and late mortality.

Methods

A simple questionnaire on early (30 days) and late mortality after LAGB and reoperation for banding was sent to 1,437 of 2,500 members of ASBS. Incidences and causes were studied.

Results

Of the 1,437 questionnaires sent, 453 (31%) were returned. Sixty-eight of the surgeons did not do any LAGBs, 350 had no operative mortalities, and 35 (9%) reported at least one operative mortality and had a total of 36 operative deaths and 19 late deaths, for a grand total of 55. Five additional deaths occurred after reoperations for LAGB, following removal, revisions, or conversions to another bariatric procedure. Of 62 deaths, the causes were: 20 (33%) cardiac origin, 11 (18%) thromboembolic, ten (16%) GI perforations, three (5%) bleedings, and 18 miscellaneous. Of all deaths, 40% occurred remotely from the band insertion date.

Conclusions

Although LAGB is technically simple, it carries a non-negligible short- and long-term mortality, with the majority being cardiac or thromboembolic. Late mortalities from LAGB and reoperations appear to be under-reported.

Presented at the Plenary Session of the 24th Annual Meeting of the American Society for Bariatric Surgery, Washington D.C., Friday, June 15, 2007.