Obesity Surgery

, Volume 21, Issue 4, pp 448–456 | Cite as

Small-diameter Bands Lead to High Complication Rates in Patients After Laparoscopic Adjustable Gastric Banding

  • Juliane Matlach
  • Daniela Adolf
  • Frank Benedix
  • Stefanie Wolff
Clinical Research

Abstract

Background

While weight loss is the primary goal of bariatric procedures, the impact of quality of life (QoL), comorbidity, and surgery-related complications continue to grow. We report on our results of patients up to 12 years of follow-up undergoing laparoscopic adjustable gastric banding (LAGB).

Methods

Preoperative data of 153 patients treated with LAGB were collected retrospectively. Questionnaires were sent to patients to analyze weight loss, complications, and comorbidities. QoL was assessed using the Bariatric Qualit-of-Life (BQL) questionnaire.

Results

Of the patients, 83.7% completed the questionnaire. Median follow-up was 8.7 years. Patients were divided into the following groups: Group A (band still in place), group B (band removed), and group C (revision surgery). A significant increase of excess BMI loss (EBL) was found in group A (p < 0.0001): EBL was 36.1%, 42.8%, 41.8%, and 37.1% after 1, 3, 5, and 8 years, respectively. Group B showed a significant weight regain after band removal (p = 0.007). One hundred ten reoperations were necessary in 67 patients (52.3%): slippage or pouch dilatation in 25.8%, band migration in 3.9%, band intolerance in 6.2%, and 62 revisions due to port complications. According to BQL, a higher EBL correlated with a significantly better assessment of QoL (p < 0.0001).

Conclusions

LAGB resulted in improvement of comorbidities and QoL in banded patients even though not all of them achieved the expected EBL. However, the high complication rate could influence patients’ outcome.

Keywords

Obesity Gastric banding Bariatric surgery Quality of life BQL EBL Complications Long-term follow-up 

Notes

Conflicts of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Benedix F, Scheidbach H, Arend J, et al. Revision after failed bariatric surgery- review of complications and current therapeutic options. Zentralbl Chir. 2009;134:214–25.CrossRefPubMedGoogle Scholar
  2. 2.
    Biagini J, Karam L. Ten years experience with laparoscopic adjustable gastric banding. Obes Surg. 2008;18:573–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Biertho L, Steffen R, Branson R, et al. Management of failed adjustable gastric banding. Surgery. 2005;137:33–41.CrossRefPubMedGoogle Scholar
  4. 4.
    Blachar A, Blank A, Gavert N, et al. Laparoscopic adjustable gastric banding surgery for morbid obesity: imaging of normal anatomic features and postoperative gastrointestinal complications. AJR Am J Roentgenol. 2007;188:472–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMedGoogle Scholar
  6. 6.
    Buchwald H, Oien DM. Metabolic/bariatric surgery Worldwide 2008. Obes Surg. 2009;19:1605–11.CrossRefPubMedGoogle Scholar
  7. 7.
    Bueter M, Maroske J, Thalheimer A, et al. Short- and long-term results of laparoscopic gastric banding for morbid obesity. Langenbecks Arch Surg. 2008;393:199–205.CrossRefPubMedGoogle Scholar
  8. 8.
    Dargent J. Pouch dilatation and slippage after adjustable gastric banding: is it still an issue? Obes Surg. 2003;13:111–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17:565–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Favretti F, Segato G, Ashton D, et al. Laparoscopic adjustable gastric banding in 1, 791 consecutive obese patients: 12-year results. Obes Surg. 2007;17:168–75.CrossRefPubMedGoogle Scholar
  11. 11.
    Fried M. The current science of gastric banding: an overview of pressure-volume theory in band adjustments. Surg Obes Relat Dis. 2008;4:S14–21.CrossRefPubMedGoogle Scholar
  12. 12.
    Korenkov M, Shah S, Sauerland S, et al. Impact of laparoscopic adjustable gastric banding on obesity co-morbidities in the medium- and long-term. Obes Surg. 2007;17:679–83.CrossRefPubMedGoogle Scholar
  13. 13.
    Lanthaler M, Mittermair R, Erne B, et al. Laparoscopic gastric re-banding versus laparoscopic gastric bypass as a rescue operation for patients with pouch dilatation. Obes Surg. 2006;16:484–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Lattuada E, Zappa MA, Mozzi E, et al. Injection port and connecting tube complications after laparoscopic adjustable gastric banding. Obes Surg. 2008;20:410–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Martikainen T, Pirinen E, Alhava E, et al. Long-term results, late complications and quality of life in a series of adjustable gastric banding. Obes Surg. 2004;14:648–54.CrossRefPubMedGoogle Scholar
  16. 16.
    Müller MK, Attigah N, Wildi S, et al. High secondary failure rate of rebanding after failed gastric banding. Surg Endosc. 2008;22:448–53.CrossRefPubMedGoogle Scholar
  17. 17.
    NHLBI (National Heart, Lung, and Blood Institute), NIH (National Institutes of Health): Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults—The Evidence Report (1998).Google Scholar
  18. 18.
    Singhal R, Kitchen M, Bridgwater S, et al. Metabolic outcomes of obese diabetic patients following laparoscopic adjustable gastric banding. Obes Surg. 2008;18:1400–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Sjöström L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes (Lond). 2008;32:S93–7.CrossRefGoogle Scholar
  20. 20.
    Steffen R, Potoczna N, Bieri N, et al. Successful multi-intervention treatment of severe obesity: a 7-year prospective study with 96% follow-up. Obes Surg. 2009;19:3–12.CrossRefPubMedGoogle Scholar
  21. 21.
    Stroh C, Hohmann U, Schramm H, et al. Long-term results after gastric banding. Zentralbl Chir. 2005;130:410–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Susmallian S, Ezri T, Elis M, et al. Access-port complications after laparoscopic gastric banding. Obes Surg. 2003;13:128–31.CrossRefPubMedGoogle Scholar
  23. 23.
    Suter M, Calmes JM, Paroz A, et al. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16:829–35.CrossRefPubMedGoogle Scholar
  24. 24.
    Weiner S, Sauerland S, Fein M, et al. The Bariatric Quality of Life index: a measure of well-being in obesity surgery patients. Obes Surg. 2005;15:538–45.CrossRefPubMedGoogle Scholar
  25. 25.
    Zinzindohoue F, Chevallier JM, Douard R, et al. Laparoscopic gastric banding: a minimally invasive surgical treatment for morbid obesity: prospective study of 500 consecutive patients. Ann Surg. 2003;237:1–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Juliane Matlach
    • 1
  • Daniela Adolf
    • 2
  • Frank Benedix
    • 1
  • Stefanie Wolff
    • 1
  1. 1.Department of General, Visceral and Vascular SurgeryOtto-von-Guericke University of MagdeburgMagdeburgGermany
  2. 2.Department of Biometrics and Medical InformaticsOtto-von-Guericke University of MagdeburgMagdeburgGermany

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