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Journal of Gastrointestinal Surgery

, Volume 11, Issue 11, pp 1470–1477 | Cite as

Prospective Evaluation and 7-Year Follow-up of Swedish Adjustable Gastric Banding in Adults with Extreme Obesity

  • Bruno M. BalsigerEmail author
  • Daniel Ernst
  • Daniel Giachino
  • Ruedi Bachmann
  • Andreas Glaettli
Article

Abstract

Background

Swedish adjustable gastric banding (SAGB) is a widespread laparoscopic procedure in bariatric surgery. Few long-term data is available.

Aim

To determine long-term outcome after SAGB in 196 patients studied prospectively.

Patients and Methods

196 patients, 40 men, and 156 women have been operated from 1996 to 2005. Age was 38 ± 1 (mean ± sem) years. Mean follow-up was 63 ± 2 months.

Results

Hospital morbidity was 3% (0.5% early reoperation); mortality was 0. Late complications were band migration (1%), leakage (5%), slipping (4%), or pouch dilatation (8%). Minor reoperations (tube replacement, port-related, and hernias) were needed in 7.5%. Cumulative major reoperation rate reached 32%. Eighteen percent had a band replacement; 14% had removal of band anatomy. Late mortality was 0.5%. Exactly 7 years after SAGB, BMI decreased from 45 ± 1 kg/m2 to 33 ± 1 kg/m2, and excess weight loss (EWL) was 61 ± 4%. Sixty-eight percent of the patients reached ≥50% EWL.

Conclusion

In 14% of the patients, the band anatomy had to be removed. Seven years of intact band anatomy leads to a successful EWL of 61 ± 4% and to EWL of ≥50% in 68%. However, cumulative major reoperation rate of 32% in 7 years makes it mandatory to offer and discuss other bariatric procedures to the respective patients.

Keywords

Extreme obesity Morbid obesity Bariatric surgery Laparoscopic Swedish adjustable gastric banding 

Notes

References

  1. 1.
    US Department of Health and Human Services. US Department of Health and Human Services, Center for Disease Control and Prevention, National Center for Health Statistics, 2004 Fact Sheet. Washington, DC: US Department of Health and Human Services, 2004.Google Scholar
  2. 2.
    WHO. WHO, Fact Sheet No 311, September 2006. Geneva, Switzerland: WHO, 2006.Google Scholar
  3. 3.
    National Center for Health Statistics. National Health and Nutrition Examination Survey. Hyattsville, MD: National Center for Health Statistics, October 6, 2004.Google Scholar
  4. 4.
    National Institute of Health. National Institute of Health Consensus Development Conference Statement, March 25–27, 1991. Washington, DC: National Institute of Health, 1991.Google Scholar
  5. 5.
    Madan AK, Orth W, Ternovits CA, Tichansky DS. Metabolic syndrome: yet another co-morbidity gastric bypass helps cure. Surg Obes Relat Dis 2006;2(1):48–51, Jan–Feb.PubMedCrossRefGoogle Scholar
  6. 6.
    Lee WJ, Huang MT, Wang W, Lin CM, Chen TC, Lai IR. Effects of obesity surgery on the metabolic syndrome. Arch Surg 2004;139(10):1088–1092, Oct.PubMedCrossRefGoogle Scholar
  7. 7.
    Cottam DR, Atkinson J, Anderson A, Grace B, Fisher B. A case-controlled matched-pair cohort study of laparoscopic Roux-en-Y gastric bypass and Lap-Band patients in a single US center with three-year follow-up. Obes Surg 2006;16(5):534–540, May.PubMedCrossRefGoogle Scholar
  8. 8.
    Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004;292(14):1724–1737, Oct 13.PubMedCrossRefGoogle Scholar
  9. 9.
    MacDonald KG Jr, Long SD, Swanson MS, Brown BM, Morris P, Dohm GL, Pories WJ. The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus. J Gastrointest Surg 1997;1(3):213–220, May–Jun.PubMedCrossRefGoogle Scholar
  10. 10.
    Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, MacLean LD. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004;240(3):416–423, Sep.PubMedCrossRefGoogle Scholar
  11. 11.
    Sugerman HJ, Kellum JM, Engle KM, Wolfe L, Starkey JV, Birkenhauer R, Fletcher P, Sawyer MJ. Gastric bypass for treating severe obesity. Am J Clin Nutr 1992;55(2 Suppl):560S–566S, Feb.PubMedGoogle Scholar
  12. 12.
    Mason EE. Vertical banded gastroplasty for obesity. Arch Surg 1982;117(5):701–706, May.PubMedGoogle Scholar
  13. 13.
    Nightengale ML, Sarr MG, Kelly KA, Jensen MD, Zinsmeister AR, Palumbo PJ. Prospective evaluation of vertical banded gastroplasty as the primary operation for morbid obesity. Mayo Clin Proc 1991;66(8):773–782, Aug.PubMedGoogle Scholar
  14. 14.
    Balsiger BM, Poggio JL, Mai J, Kelly KA, Sarr MG. Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity. J Gastrointest Surg 2000;4(6):598–605, Nov–Dec.PubMedCrossRefGoogle Scholar
  15. 15.
    Belachew M, Jacqet P, Lardinois F, Karler C. Vertical banded gastroplasty vs adjustable silicone gastric banding in the treatment of morbid obesity: a preliminary report. Obes Surg 1993;3(3):275–278, Aug.PubMedCrossRefGoogle Scholar
  16. 16.
    Cadiere GB, Bruyns J, Himpens J, Favretti F. Laparoscopic gastroplasty for morbid obesity. Br J Surg 1994;81(10):1524, Oct.PubMedCrossRefGoogle Scholar
  17. 17.
    Morino M, Toppino M, Garrone C, Morino F. Laparoscopic adjustable silicone gastric banding for the treatment of morbid obesity. Br J Surg 1994;81(8):1169–1170, Aug.PubMedCrossRefGoogle Scholar
  18. 18.
    Oria HE, Moorehead MK. Bariatric analysis and reporting outcome system (BAROS). Obes Surg 1998;8(5):487–499, Oct.PubMedCrossRefGoogle Scholar
  19. 19.
    Fravetti F, Cadiere GB, Segato G, Busetto L, Loffredo A, Vertruyen M, Enzi G, Caniato D, De Marchi F, Lise M. Bariatric Analysis and reporting outcome system (BAROS) applied to laparoscopic gastric banding patients. Obes Surg 1998;8:500–504.CrossRefGoogle Scholar
  20. 20.
    Wolf AM, Falcone AR, Kortner B, Kuhlmann HW. BAROS: an effective system to evaluate the results of patients after bariatric surgery. Obes Surg 2000;10(5):445–450, Oct.PubMedCrossRefGoogle Scholar
  21. 21.
    Klaiber C, Metzger A, Forsell P. Laparoscopic gastric banding. Chirurg 2000;71(2):146–151, Feb.PubMedGoogle Scholar
  22. 22.
    Zehetner J, Holzinger F, Triaca H, Klaiber Ch. A 6-year experience with the Swedish adjustable gastric band. Prospective long-term audit of laparoscopic gastric banding. Surg Endosc 2005;19(1):21–28, Jan.PubMedCrossRefGoogle Scholar
  23. 23.
    Suter M, Giusti V, Worreth M, Heraief E, Calmes JM. Laparoscopic gastric banding: a prospective, randomized study comparing the Lapband and the SAGB: early results. Ann Surg 2005;241(1):55–62, Jan.PubMedGoogle Scholar
  24. 24.
    Miller K, Pump A, Hell E. Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow-up study. Surg Obes Relat Dis 2007;3(1):84–90, Jan–Feb.PubMedCrossRefGoogle Scholar
  25. 25.
    Vlassov VV. Long-term outcome of bariatric surgery. N Engl J Med 2005;352(14):1495–1496, Apr 7.PubMedCrossRefGoogle Scholar
  26. 26.
    Zinzindohoue F, Chevallier JM, Douard R, Elian N, Ferraz JM, Blanche JP, Berta JL, Altman JJ, Safran D, Cugnenc PH. Laparoscopic gastric banding: a minimally invasive surgical treatment for morbid obesity: prospective study of 500 consecutive patients. Ann Surg 2003;237(1):1–9, Jan.PubMedCrossRefGoogle Scholar
  27. 27.
    Ceelen W, Walder J, Cardon A, Van Renterghem K, Hesse U, El Malt M, Pattyn P. Surgical treatment of severe obesity with a low-pressure adjustable gastric band: experimental data and clinical results in 625 patients. Ann Surg 2003;237(1):10–16, Jan.PubMedCrossRefGoogle Scholar
  28. 28.
    Chapman AE, Kiroff G, Game P, Foster B, O’Brien P, Ham J, Maddern GJ. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135(3):326–351, Mar.PubMedCrossRefGoogle Scholar
  29. 29.
    Frering V, Vicard P, Stagny R, et al. Banding gastrique coelioscopique: incidence du type d’ anneau gastrique sur les complications. J Coeliochir. 2000;35:21–24.Google Scholar
  30. 30.
    Crookes PF. Surgical treatment of morbid obesity. Annu Rev Med 2006;57:243–264.PubMedCrossRefGoogle Scholar
  31. 31.
    McMahon MM, Sarr MG, Clark MM, Gall MM, Knoetgen J 3rd, Service FJ, Laskowski ER, Hurley DL. Clinical management after bariatric surgery: value of a multidisciplinary approach. Mayo Clin Proc 2006;81(10 Suppl):S34–45, Oct.PubMedGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2007

Authors and Affiliations

  • Bruno M. Balsiger
    • 1
    • 2
    • 3
    Email author
  • Daniel Ernst
    • 3
  • Daniel Giachino
    • 2
  • Ruedi Bachmann
    • 2
  • Andreas Glaettli
    • 1
  1. 1.Division of Visceral SurgeryHirslanden Salem-SpitalBernSwitzerland
  2. 2.Division of General and Visceral SurgerySpital Netz Bern TiefenauBernSwitzerland
  3. 3.Division of Internal MedicineSpital Netz Bern TiefenauBernSwitzerland

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