Obesity Surgery

, Volume 21, Issue 8, pp 1272–1279 | Cite as

Systematic Review of Erosion after Laparoscopic Adjustable Gastric Banding

  • Kristine Egberts
  • Wendy A. Brown
  • Paul E. O’Brien
Review

Abstract

Erosion of the laparoscopic adjustable gastric band (LAGB) into the lumen of the stomach is a recognised complication of this procedure. We undertook a systematic literature review of the incidence, clinical features and management of erosions occurring after LAGB. A systematic search of relevant medical databases for full-text original articles looking for LAGB patients and reported erosions was conducted. We focussed on incidence, aetiology, clinical presentation, treatment, complications and weight loss. Twenty-five studies of LAGB reported 231 erosions in 15,775 patients (overall incidence of 1.46%). The mean number of patients per study was 631 (±486), and the mean follow-up was 3.73 (±2.4) years. In four reports involving less than 100 patients, there were 27 erosions in a total of 270 patients (10%) compared with 180 erosions in 12,978 patients (1.386%) in the remaining 21 reports. Multiple regression analysis showed that erosion rate was significantly predicted by number of patients and number of years of surgeon experience (r 2 = 0.186). Treatment was most commonly by removal of the band, repair of the stomach and later, band replacement. Other options were removal alone or conversion to another procedure. Weight loss was retained after treatment of the erosion with a mean weight loss at final follow-up of 50.34 ± 3.9 percent excess weight loss. Incidence of erosion after gastric banding is relatively low and can be related to surgeon experience. The most common treatment described in the literature is removal of the eroded band with delayed replacement. Replacement of the band is associated with maintenance of weight loss.

Keywords

Laparoscopic adjustable gastric banding Surgery Erosion Weight loss 

Notes

Disclosures

The Centre for Obesity Research and Education receives an unrestricted grant from Allergan, the manufacturer of the Lap-Band™. They also receive educational funding from Applied Medical.

The author Wendy Brown received an honorarium from Allergan, the manufacturer of the Lap-Band™, for attending a scientific advisory panel in London in 2009.

References

  1. 1.
    O'Brien PE, Dixon JB, Brown W, et al. The laparoscopic adjustable gastric band (Lap-Band): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg. 2002;12(5):652–60.PubMedCrossRefGoogle Scholar
  2. 2.
    Chapman A, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic review. Surg. 2004;135:326–51.CrossRefGoogle Scholar
  3. 3.
    Colquitt J, Clegg A, Loveman E et al. Surgery for morbid obesity. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD003641. doi: 10.1002/14651858.CD003641
  4. 4.
    O'Brien PE, Brown WA. Obesity, weight loss and bariatric surgery. Med J Aust. 2005;183(6):310–4.PubMedGoogle Scholar
  5. 5.
    Dixon AF, Dixon JB, O’Brien P. Laparoscopic adjustable gastric banding induces prolonged satiety: a randomised blind crossover study. J Clin Endocrinol Metab. 2005;90(2):813–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Weiner R, Emmerlich V, Wagner D, et al. Management and therapy of postoperative complications after "gastric banding" for morbid obesity. Chirurg. 1998;69(10):1082–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
  8. 8.
    Angrisani L, Di Lorenzo N. The Italian Group for LAP-BAND: predictive value of initial body mass index for weight loss after 5 years of follow-up. Surg Endosc. 2004;18(10):1524–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Ren CJ, Weiner M. Favorable early results of gastric banding for morbid obesity: the American experience. Surg Endosc. 2004;18(3):543–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Abu-Abeid S, Zohar DB. Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement. Obes Surg. 2005;15(6):849–52.PubMedCrossRefGoogle Scholar
  11. 11.
    Meir E, Van Baden M. Adjustable silicone gastric banding and band erosion: personal experience and hypotheses. Obes Surg. 1999;9(2):191–3.PubMedCrossRefGoogle Scholar
  12. 12.
    Boschi S, Fogli L. Avoiding complications after laparoscopic esophago-gastric banding: experience with 400 consecutive patients. Obes Surg. 2006;16(9):1166–70.PubMedCrossRefGoogle Scholar
  13. 13.
    Greenslade J, Kow L. Surgical management of obesity using a soft adjustable gastric band. ANZ J Surg. 2004;74(4):195–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Rubin M, Spivak H. Prospective study of 250 patients undergoing laparoscopic gastric banding using the two-step technique: a technique to prevent postoperative slippage. Surg Endosc. 2003;17(6):857–60.PubMedCrossRefGoogle Scholar
  15. 15.
    Weiner R, Wagner D. Laparoscopic gastric banding for morbid obesity. J Laparoendosc Adv Surg Tech. 1999;9(1):23–30.CrossRefGoogle Scholar
  16. 16.
    Kurian M, Sultan S, Garg K, et al. Evaluating gastric erosion in band management: an algorithm for stratification of risk. Surg Obes Relat Dis. 2010;6(4):386–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Angrisani LM, Alkilani A. Laparoscopic Italian experience with the Lap-Band. Obes Surg. 2001;11(3):307–10.PubMedCrossRefGoogle Scholar
  18. 18.
    Dargent J. Esophageal dilatation after laparoscopic adjustable gastric banding: definition and strategy. Obes Surg. 2005;15(6):843–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Rubenstein RB. Laparoscopic adjustable gastric banding at a U.S. center with up to 3-year follow-up. Obes Surg. 2002;12(3):380–4.PubMedCrossRefGoogle Scholar
  20. 20.
    Calmes JM, Giusti V, Suter M. Reoperative laparoscopic Roux-en-Y gastric bypass: an experience with 49 cases. Obes Surg. 2005;15(3):316–22.PubMedCrossRefGoogle Scholar
  21. 21.
    Cadiere GB, Himpens J. Laparoscopic adjustable gastric banding. Semin Laparosc Surg. 2002;9(2):105–14.PubMedCrossRefGoogle Scholar
  22. 22.
    Collet DA, Rault A. Laparoscopic adjustable gastric banding results after 2 years with two different band types. Obes Surg. 2005;15(6):853–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Vertruyen M, Paul G. 11-cm Lap-Band System placement after history of intragastric migration. Obes Surg. 2003;13(3):435–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Niville E, Dams A. Lap-Band erosion: incidence and treatment. Obes Surg. 2001;11(6):744–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Himpens J, Dapri G. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Schouten R, van Dielen FM. Re-operation after laparoscopic adjustable gastric banding leads to a further decrease in BMI and obesity-related co-morbidities: results in 33 patients. Obes Surg. 2006;16(7):821–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Belachew M, Belva PH, et al. Long-term results of laparoscopic adjustable gastric banding for the treatment of morbid obesity. Obes Surg. 2002;12(4):564–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Lyass S, Cunneen SA. Device-related reoperations after laparoscopic adjustable gastric banding. Am Surg. 2005;71(9):738–43.PubMedGoogle Scholar
  29. 29.
    Niville E, Dams A. Results of lap rebanding procedures after Lap-Band removal for band erosion—a mid-term evaluation. Obes Surg. 2005;15(5):630–3.PubMedCrossRefGoogle Scholar
  30. 30.
    van Dielen FM, Soeters PB. Laparoscopic adjustable gastric banding versus open vertical banded gastroplasty: a prospective randomized trial. Obes Surg. 2005;15(9):1292–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Victorzon M, Tolonen P. Intermediate results following laparoscopic adjustable gastric banding for morbid obesity. Dig Surg. 2002;19(5):354–7. discussion 358.PubMedCrossRefGoogle Scholar
  32. 32.
    Abu-Abeid S, Szold A. Laparoscopic management of Lap-Band erosion. Obes Surg. 2001;11(1):87–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Gupta V, Biedenbach A, Stephens KW, et al. Laparoscopic conversion of eroded adjustable gastric band to vertical sleeve gastrectomy. Surg Obes Relat Dis. 2010;6(5):548–50.PubMedCrossRefGoogle Scholar
  34. 34.
    O’Brien P. Comment on: endoscopic removal of eroded adjustable gastric band: lessons learned after 5 years and 78 cases. Surg Obes Relat Dis. 2010;6(4):427–8.PubMedCrossRefGoogle Scholar
  35. 35.
    O’Brien PE, Dixon JB. Weight loss and early and late complications—the international experience. Am J Surg. 2002;184(6B):42S–5S.PubMedCrossRefGoogle Scholar
  36. 36.
    Martikainen T, Pirinen E. Long-term results, late complications and quality of life in a series of adjustable gastric banding. Obes Surg. 2004;14(5):648–54.PubMedCrossRefGoogle Scholar
  37. 37.
    Silecchia G, Restuccia A, Elmore U, et al. Laparoscopic adjustable silicone gastric banding: prospective evaluation of intragastric migration of the lap-band. Surg Laparosc Endosc Percutan Tech. 2001;11(4):229–34.PubMedCrossRefGoogle Scholar
  38. 38.
    Westling A, Ohrvall M, Gustavsson S. Roux-en-Y gastric bypass after previous unsuccessful gastric restrictive surgery. J Gastrointest Surg. 2002;6(2):206–11.PubMedCrossRefGoogle Scholar
  39. 39.
    Westling A, Bjurling K, Ohrvall M, et al. Silicone-adjustable gastric banding: disappointing results. Obes Surg. 1998;8(4):467–74.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2011

Authors and Affiliations

  • Kristine Egberts
    • 1
  • Wendy A. Brown
    • 1
    • 2
  • Paul E. O’Brien
    • 1
  1. 1.Centre for Obesity Research and Education (CORE), The Alfred CentreMonash University MelbourneMelbourneAustralia
  2. 2.Monash University Department of Surgery, The Alfred HospitalMelbourneAustralia

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