Abstract
Background
Weight loss and overall outcomes following laparoscopic adjustable gastric banding (LAGB) are more variable than with other bariatric procedures. Our aim was to investigate the predictive value of certain parameters in a cohort of 794 patients with 10 years’ minimum follow-up after LAGB.
Methods
We retrospectively reviewed the records of 794 patients undergoing LAGB performed by the authors between April 1996 and December 2004. We collected patients’ data on weight loss and band-related complications and performed logistic regression modelling and calculated Kaplan–Meier curves for band preservation.
Results
The follow-up rate at 10 years was 90.4%. The mean follow-up duration was 15.1 years (range, 120–228 months). Overall band removal with or without conversion or replacement was required in 304 (38.2%) patients. The mean survival time of the band was 148.4 months (95% confidence interval: 138.3–167.4), and there was no difference in the rate of removal by operative technique (p = 0.7). The highest rate of band removal occurred in female patients (p = 0.05), those with BMI > 50 kg/m2 (p = 0.005) and in those <40 years of age (p = 0.04). For patients with the band in situ, the success rate was significantly lower in patients with initial BMI > 50 kg/m2. Conversely, differences in success rate were not statistically significant for age (using 50 years as the cut-off), technique or sex.
Conclusions
Higher rates of removal occurred in women, younger patients and those with BMI > 50 kg/m2. Regardless of these criteria, the rate of band removal for complications rose over time. Patients should be informed of the high risk of the need for band removal long-term.
Similar content being viewed by others
References
Belachew M, Legrand M, Vincenti VV et al (1995) Laparoscopic placement of adjustable silicone gastric band in the treatment of morbid obesity: How to do it. Obes Surg 5:66–70
Buchwald H, Avidor Y, Braunwald E et al (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737
Weiner R, Bockhorn H, Rosenthal R, Wagner D (2001) A prospective randomized trial of different laparoscopic gastric banding techniques for morbid obesity. Surg Endosc 15:63–68
Rubin M, Spivak H (2003) Prospective study of 250 patients undergoing laparoscopic gastric banding using the two-step technique: a technique to prevent postoperative slippage. Surg Endosc 17:857–860
Busetto L, Segato G, De Marchi F et al (2002) Outcome predictors in morbidly obese recipients of an adjustable gastric band. Obes Surg 12:83–92
Dixon JB, Dixon ME, O’Brien PE (2001) Pre-operative predictors of weight loss at 1-year after Lap-Band surgery. Obes Surg 11:200–207
Branson R, Potoczna N, Brunotte R et al (2005) Impact of age, sex and body mass index on outcomes at four years after gastric banding. Obes Surg 15:834–842
Biertho L, Steffen R, Ricklin T et al (2003) Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg 197:536–544; discussion 544–535
Chau WY, Schmidt HJ, Kouli W et al (2005) Patient characteristics impacting excess weight loss following laparoscopic adjustable gastric banding. Obes Surg 15:346–350
Bueter M, Thalheimer A, Lager C et al (2007) Who benefits from gastric banding? Obes Surg 17:1608–1613
Wolnerhanssen BK, Peters T, Kern B et al (2008) Predictors of outcome in treatment of morbid obesity by laparoscopic adjustable gastric banding: results of a prospective study of 380 patients. Surg Obes Relat Dis 4:500–506
Kasza J, Brody F, Vaziri K et al (2011) Analysis of poor outcomes after laparoscopic adjustable gastric banding. Surg Endosc 25:41–47
Colquitt JL, Picot J, Loveman E, Clegg AJ (2009) Surgery for obesity. Cochrane Database Syst Rev CD003641
Gastrointestinal surgery for severe obesity (1992) National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr 55:615S–619S
Reinhold RB (1982) Critical analysis of long term weight loss following gastric bypass. Surg Gynecol Obstet 155:385–394
Chevallier JM, Paita M, Rodde-Dunet MH et al (2007) Predictive factors of outcome after gastric banding: a nationwide survey on the role of center activity and patients’ behavior. Ann Surg 246:1034–1039
Tice JA, Karliner L, Walsh J et al (2008) Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med 121:885–893
Busetto L, Mozzi E, Schettino AM et al (2015) Three years durability of the improvements in health-related quality of life observed after gastric banding. Surg Obes Relat Dis 11:110–117
Zitsman JL, DiGiorgi MF, Fennoy I et al (2015) Adolescent laparoscopic adjustable gastric banding (LAGB): prospective results in 137 patients followed for 3 years. Surg Obes Relat Dis 11:101–109
O’Brien PE, MacDonald L, Anderson M et al (2013) Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg 257:87–94
Aarts EO, Dogan K, Koehestanie P et al (2014) Long-term results after laparoscopic adjustable gastric banding: a mean fourteen year follow-up study. Surg Obes Relat Dis 10:633–640
Kindel T, Martin E, Hungness E, Nagle A (2014) High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surg Obes Relat Dis 10:1070–1075
O’Brien PE, Dixon JB, Laurie C, Anderson M (2005) A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg 15:820–826
Trujillo MR, Muller D, Widmer JD et al (2016) Long-term follow-up of gastric banding 10 years and beyond. Obes Surg 26(3):581–587
Gero D, Dayer-Jankechova A, Worreth M et al (2014) Laparoscopic gastric banding outcomes do not depend on device or technique. Long-term results of a prospective randomized study comparing the Lapband (R) and the SAGB (R). Obes Surg 24:114–122
Welch G, Wesolowski C, Piepul B et al (2008) Physical activity predicts weight loss following gastric bypass surgery: findings from a support group survey. Obes Surg 18:517–524
Burgmer R, Grigutsch K, Zipfel S et al (2005) The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg 15:684–691
Mifflin MD, St Jeor ST, Hill LA et al (1990) A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr 51:241–247
Hudson JI, Hiripi E, Pope HG Jr, Kessler RC (2007) The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biol Psychiatry 61:348–358
Forsell P, Hallerback B, Glise H, Hellers G (1999) Complications following Swedish adjustable gastric banding: a long-term follow-up. Obes Surg 9:11–16
DeMaria EJ, Sugerman HJ, Meador JG et al (2001) High failure rate after laparoscopic adjustable silicone gastric banding for treatment of morbid obesity. Ann Surg 233:809–818
te Riele WW, Boerma D, Wiezer MJ et al (2010) Long-term results of laparoscopic adjustable gastric banding in patients lost to follow-up. Br J Surg 97:1535–1540
Valle E, Luu MB, Autajay K et al (2012) Frequency of adjustments and weight loss after laparoscopic adjustable gastric banding. Obes Surg 22:1880–1883
Himpens J, Cadiere GB, Bazi M et al (2011) Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg 146:802–807
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Drs. Tammaro P., Hansel B., Police A., Kousouri M., Magnan C., Marmuse J.P. and Arapis K. have no conflicts of interest or financial ties to disclose.
Rights and permissions
About this article
Cite this article
Tammaro, P., Hansel, B., Police, A. et al. Laparoscopic Adjustable Gastric Banding: Predictive Factors for Weight Loss and Band Removal After More than 10 Years’ Follow-Up in a Single University Unit. World J Surg 41, 2078–2086 (2017). https://doi.org/10.1007/s00268-017-3922-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-017-3922-x