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Endoscopic Management of Gastric Band Erosion: a Systematic Review and Meta-Analysis

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Abstract

Background

Gastric band erosion may be seen in up to 3% of patients. Endoscopic intervention has become increasingly utilized due to its minimally invasive nature. The purpose of this study was to perform a systematic review and meta-analysis to examine the role of endoscopic removal for eroded gastric bands.

Methods

Individualized search strategies were developed for PubMed, EMBASE, Web of Science, and Cochrane Library databases in accordance with PRISMA and MOOSE guidelines. Outcomes included technical success, clinical success, procedure duration, adverse events, and surgical conversion. Pooled proportions were analyzed using random effects models. Heterogeneity and publication bias was assessed with I2 statistics and funnel plot asymmetry using Egger and Begg tests. Meta-regression was also performed comparing outcomes by endoscopic tools.

Results

Ten studies (n=282 patients) were included in this meta-analysis. Mean age was 40.68±7.25 years with average duration of band placement of 38.49±19.88 months. Pre-operative BMI was 42.76±1.06 kg/m2 with BMI of 33.06±3.81 kg/m2 at time of band erosion treatment. Endoscopic removal was attempted in 240/282 (85.11%) of cases. Pooled technical and clinical success of the endoscopic therapy was 86.08% (95% CI: 79.42–90.83; I2=28.62%) and 85.34% (95% CI: 88.70–90.62; I2=38.56%), respectively. Mean procedure time for endoscopic removal was 46.47±11.52 min with an intra-operative adverse event rate of 4.15% (95% CI: 1.98–8.51; I2=0.00%). Post-procedure-associated adverse events occurred in 7.24% (CI: 4.46–11.55; I2=0.00%) of patients. Conversion to laparotomy/laparoscopy occurred in 10.54% (95% CI: 6.12–17.54) of cases.

Conclusion

Endoscopic intervention is a highly effective and safe modality for the treatment of gastric band erosion.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, School of Medicine, Saint Louis University, St. Louis, MO, 63104, USA

    Ameya Deshmukh

  2. Division of Gastroenterology and Hepatology, Tower Health, Reading Hospital, Reading, PA, 19611, USA

    Parth M. Desai

  3. Department of Internal Medicine, School of Medicine, Washington University, St. Louis, MO, 63110, USA

    Christine Ma

  4. Division of Gastroenterology, Hepatology and Endoscopy, School of Medicine, Washington University, 660 S Euclid Ave, St. Louis, MO, 63110, USA

    Vladimir Kushnir & Ahmad Najdat Bazarbashi

  5. Department of Surgery, School of Medicine, Washington University, St. Louis, MO, 63110, USA

    Shaina Eckhouse & Francesca M. Dimou

  6. Lynda K. and David M. Underwood Center for Digestive Disorders, Houston Methodist Hospital, Houston, TX, 77030, USA

    Thomas R. McCarty

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  1. Ameya Deshmukh
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  3. Christine Ma
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  8. Ahmad Najdat Bazarbashi
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Contributions

Literature review, data extraction, drafting of manuscript, and critical revision of manuscript: AD, PD, CM, VK, and FD. Literature review, adjudication, statistical analysis, and critical revision of manuscript: TRM. Concept and design and critical revision of manuscript: CCT and ANB.

Corresponding author

Correspondence to Ahmad Najdat Bazarbashi.

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Key points

• Endoscopic intervention for gastric band erosion has high success rates.

• Endoscopic removal has low rates of intra- and post-operative adverse events.

• Surgical conversion took place in 10% of cases due to endoscopic failure.

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Deshmukh, A., Desai, P.M., Ma, C. et al. Endoscopic Management of Gastric Band Erosion: a Systematic Review and Meta-Analysis. OBES SURG 34, 494–502 (2024). https://doi.org/10.1007/s11695-023-06995-4

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  • DOI: https://doi.org/10.1007/s11695-023-06995-4

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