, Volume 21, Issue 5, pp 574-581
Date: 09 Feb 2010

Outcomes, Satiety, and Adverse Upper Gastrointestinal Symptoms Following Laparoscopic Adjustable Gastric Banding

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Abstract

Background

Follow-up is critical to the success of laparoscopic adjustable gastric banding (LAGB). Few data guide this and expected norms of satiety, adverse symptoms, and outcomes have not been defined.

Methods

Consecutive patients, who underwent LAGB, were evaluated using a newly developed instrument that assessed satiety, adverse upper gastrointestinal (dysphagia, reflux, and epigastric pain), and outcomes (overall satisfaction, weight loss, and quality of life (SF-36)).

Results

Three hundred twenty-three of 408 patients responded (80%; mean age 44.4 ± 11.8 years, 56 males). Excess weight loss was 52%. Satiety was greater at breakfast compared to lunch (5.3 ± 1.9 vs. 4.1 ± 1.7, p < 0.005) or dinner (3.8 ± 1.8, p < 0.005). The satisfaction score was 8.3 ± 2.1 out of 10, and 91% would have the surgery again. Quality of life was less than community norms, except in physical functioning (83.4 ± 20.5 vs. 84.7 ± 22.0, p = 0.25) and bodily pain (78.4 ± 15.2 vs. 75.9 ± 25.3, p = 0.004). Inability to consume certain foods was cited as the biggest problem by 66% of respondents. The dysphagia score was 19.9 ± 8.7; softer foods were tolerated, although difficulty was noted with firmer foods. The reflux score was 8.7 ± 9.8 and regurgitation occurred a mean of once per week. Weight loss and the mental component score were the only predictors of overall satisfaction (r 2 = 0.46, p = 0.01).

Conclusions

Patients are highly satisfied with the outcome of LAGB and achieve substantial weight after 3 years. Expected ranges of satiety, adverse symptoms, and outcomes have been defined. The most troublesome symptom is the inability to consume certain foods. Weight loss predicted overall satisfaction, regardless of adverse symptoms.

Grant support: Paul Burton has received funding from the National Health and Medical Research Council (NHMRC) and the Royal Australasian College of Surgeons.