Advertisement

Obesity Surgery

, Volume 29, Issue 2, pp 499–505 | Cite as

Gastric Banding: Complications Identified by CT

  • Ariel KerpelEmail author
  • Eyal Klang
  • Eli Konen
  • Edith Michelle Marom
  • Marianne Michal Amitai
Original Contributions
  • 79 Downloads

Abstract

Purpose

Laparoscopic adjustable gastric banding (LAGB) used to be a common procedure at the turn of the century and is still frequently encountered on CT scans in common clinical practice. Our aim is to present the frequency and spectrum of complication associated with LAGB, as observed in CT.

Materials and Methods

After approval of our institutional review board, a retrospective search for LAGB in CT interpretations using the term “band” between December 2011 and April 2017 was conducted. CT scans were reviewed to identify complications. The findings were divided into two groups: symptomatic, in which the complications caused acute symptoms for which CT scans were conducted, and incidental, in which complications were incidentally identified. The frequency of complications was calculated.

Results

We identified 160 patients who underwent LAGB and performed a CT scan. Complications were identified in 69/160 (43.1%) patients, with a total of 83 findings: 47/160 (29.4%) esophageal dilatation, 13/160 (8.2%) pulmonary complications, 6/160 (3.8%) abdominal abscesses, 5/160 (3.1%) small bowel obstructions, 4/160 (2.5%) intragastric band erosions, 4/160 (2.5%) tube disconnections, 3/160 (1.9%) port site and tube course infections, and 1/160 (0.6%) small pouch bezoars. When compared with patients’ referral notes, 38/83 (45.8%) of the findings were associated with acute symptoms, whereas 45/83 (54.2%) of the findings were incidental. Eighteen percent of the incidental complications were clinically important.

Conclusion

Complications were found in 43% of CT scans of patients who underwent LAGB; less than half of the findings were symptomatic. Some of the incidentally identified complications had substantial clinical importance.

Keywords

LAGB, Laparoscopic adjustable gastric banding CT, computed tomography, complications, band erosion 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

This study is a retrospective study. Informed consent statement does not apply.

References

  1. 1.
    Ahima RS. In: Ahima RS, editor. Obesity epidemiology, pathogenesis, and treatment: a multidisciplinary approach. 1st ed. New York: Apple Academic Press; 2014.CrossRefGoogle Scholar
  2. 2.
    Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.  https://doi.org/10.1056/NEJMoa066254.CrossRefGoogle Scholar
  3. 3.
    Romero-Corral A, Montori VM, Somers VK, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet. 2006;368(9536):666–78.  https://doi.org/10.1016/S0140-6736(06)69251-9.CrossRefGoogle Scholar
  4. 4.
    Blackburn G. Effect of degree of weight loss on health benefits. Obes Res. 1995;(3 Suppl 2):211s–6s. http://www.ncbi.nlm.nih.gov/pubmed/8581779.
  5. 5.
    Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. In: Colquitt JL, editor. Cochrane Database of Systematic Reviews. Chichester: Wiley; 2014.  https://doi.org/10.1002/14651858.CD003641.pub4.Google Scholar
  6. 6.
    Gulliford MC, Charlton J, Prevost T, et al. Costs and outcomes of increasing access to bariatric surgery: cohort study and cost-effectiveness analysis using electronic health records. Value Health. 2017;20(1):85–92.  https://doi.org/10.1016/j.jval.2016.08.734.CrossRefGoogle Scholar
  7. 7.
    Sonavane SK, Menias CO, Kantawala KP, et al. Laparoscopic adjustable gastric banding: what radiologists need to know. Radiographics. 2012;32(4):1161–78.  https://doi.org/10.1148/rg.324115177.CrossRefGoogle Scholar
  8. 8.
    Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.  https://doi.org/10.1007/s11695-012-0864-0.CrossRefGoogle Scholar
  9. 9.
    Booth HP, Khan O, Fildes A, et al. Changing epidemiology of bariatric surgery in the UK: cohort study using primary care electronic health records. Obes Surg. 2016;26(8):1900–5.  https://doi.org/10.1007/s11695-015-2032-9.CrossRefGoogle Scholar
  10. 10.
    Vinzens F, Kilchenmann A, Zumstein V, et al. Long-term outcome of laparoscopic adjustable gastric banding (LAGB): results of a Swiss single-center study of 405 patients with up to 18 years’ follow-up. Surg Obes Relat Dis. 2017;13(8):1313–9.  https://doi.org/10.1016/j.soard.2017.04.030.CrossRefGoogle Scholar
  11. 11.
    Khoraki J, Moraes MG, Neto APF, et al. Long-term outcomes of laparoscopic adjustable gastric banding. Am J Surg. 2018;215(1):97–103.  https://doi.org/10.1016/j.amjsurg.2017.06.027.CrossRefGoogle Scholar
  12. 12.
    Carandina S, Tabbara M, Galiay L, et al. Long-term outcomes of the laparoscopic adjustable gastric banding: weight loss and removal rate. A single center experience on 301 patients with a minimum follow-up of 10 years. Obes Surg. 2017;27(4):889–95.  https://doi.org/10.1007/s11695-016-2391-x.CrossRefGoogle Scholar
  13. 13.
    Aditya BS, Wilding JPH. Modern management of obesity. Clin Med. 2009;9(6):617–21. quiz 622-3. http://www.ncbi.nlm.nih.gov/pubmed/20095314. CrossRefGoogle Scholar
  14. 14.
    Ponce J, DeMaria EJ, Nguyen NT, et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in 2015 and surgeon workforce in the United States. Surg Obes Relat Dis. 2016;12(9):1637–9.  https://doi.org/10.1016/j.soard.2016.08.488.CrossRefGoogle Scholar
  15. 15.
    Dargent J. Laparoscopic gastric banding: game over? Obes Surg. 2017;27(8):1914–6.  https://doi.org/10.1007/s11695-017-2710-x.CrossRefGoogle Scholar
  16. 16.
    Mendes-Castro A, Montenegro J, Cardoso JF, et al. Laparoscopic adjustable gastric band: complications, removal and revision in a Portuguese highly differentiated obesity treatment center. Acta Medica Port. 28(6):735–40. http://www.ncbi.nlm.nih.gov/pubmed/26849758.
  17. 17.
    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(2):472–9.  https://doi.org/10.2214/AJR.05.0293.CrossRefGoogle Scholar
  18. 18.
    Levine MS, Carucci LR. Imaging of bariatric surgery: normal anatomy and postoperative complications. Radiology. 2014;270(2):327–41.  https://doi.org/10.1148/radiol.13122520.CrossRefGoogle Scholar
  19. 19.
    Shen X, Zhang X, Bi J, et al. Long-term complications requiring reoperations after laparoscopic adjustable gastric banding: a systematic review. Surg Obes Relat Dis. 11(4):956–64.  https://doi.org/10.1016/j.soard.2014.11.011.
  20. 20.
    Flowers D, Pearce O, Somers S, et al. Gastric bands: what the general radiologist should know. Clin Radiol. 2013;68(5):488–99.  https://doi.org/10.1016/j.crad.2012.08.020.CrossRefGoogle Scholar
  21. 21.
    Savir S, Kalchiem-Dekel O, Naggan L, et al. Respiratory deterioration following laparoscopic adjustable gastric banding: a three-year follow-up of over 3,000 subjects. Respir Med. 2016;115:66–71.  https://doi.org/10.1016/j.rmed.2016.04.014.CrossRefGoogle Scholar
  22. 22.
    Avriel A, Warner E, Avinoach E, et al. Major respiratory adverse events after laparascopic gastric banding surgery for morbid obesity. Respir Med. 2012;106(8):1192–8.  https://doi.org/10.1016/j.rmed.2012.05.002.CrossRefGoogle Scholar
  23. 23.
    Galgano SJ, Sonavane SK, Sanyal R, et al. Thoracic imaging after bariatric surgery. J Thorac Imaging. 2017;32(5):W45–53.  https://doi.org/10.1097/RTI.0000000000000286.CrossRefGoogle Scholar
  24. 24.
    Naef M, Mouton WG, Naef U, et al. Esophageal dysmotility disorders after laparoscopic gastric banding—an underestimated complication. Ann Surg. 2011;253(2):285–90.  https://doi.org/10.1097/SLA.0b013e318206843e.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of MedicineTel Aviv UniversityRamat GanIsrael

Personalised recommendations