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Benchmarking hospital outcomes for laparoscopic adjustable gastric banding

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Abstract

Background

Since the Food and Drug Administration (FDA) approval of laparoscopic adjustable gastric bands (LAGB) in June 2001, the number LAGB procedures performed in the United States has increased exponentially. This study aimed to benchmark the authors’ initial hospital experience to FDA research trials and evidence-based literature.

Methods

Over a 2-year period, 87 consecutive patients with a mean age of 43 years (range, 21–64 years) and a body mass index of 45.6 kg/m2 (range, 35–69 kg/m2) underwent an LAGB procedure at the authors’ institution. The authors conducted a retrospective review of the outcomes including conversion, reoperation, mortality, perforation, erosion, prolapse, port dysfunction, excess weight loss, and changes in comorbidities, then compared the data with published benchmarks.

Results

Gender, age, and body mass index were comparable with those of other series. Perioperative adverse events included acute stoma obstruction (n = 1) and respiratory complications (n = 2). Delayed complications included gastric prolapse (n = 4) and port reservoir malposition (n = 4). Five bands were explanted. The mean follow-up period was 14 months (n = 79). The mean percentage of excess weight loss was 30% (range, 4.7–69%) at 6 months, 41% (range, 9.6–82%) at 12 months, and 47% (range, 14–92%) at 24 months. Comorbidities resolved included diabetes (74%), hypertension (57%), gastroesophageal reflux disease (55%) and dyslipidemia (38%).

Conclusions

The short-term outcomes for LAGB were comparable with published benchmarks. With adequate weight loss, most patients achieve significant improvement in obesity-related illnesses. With new bariatric accreditation standards and mandates required for financial reimbursement, hospitals will need to demonstrate that their clinical outcomes are consistent with best practices. The authors’ early experience shows that LAGB achieves significant weight loss with low mortality and morbidity rates. Despite a more gradual weight loss, most patients achieve excellent weight loss with corresponding improvement of comorbidities within the first 2 years postoperatively.

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Authors and Affiliations

  1. Department of Surgery, Medical College of Georgia, 1120 15th Street, BI 4072, Augusta, GA, 30912, USA

    M. A. Edwards

  2. Department of Surgery, Beth Isreal Deaconess Medical Center, 330 Brookline Avenue, Shapiro 3C, Boston, MA, 02215, USA

    R. Grinbaum, B. E. Schneider, A. Walsh, J. Ellsmere & D. B. Jones

Authors
  1. M. A. Edwards
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  2. R. Grinbaum
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  3. B. E. Schneider
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  4. A. Walsh
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  5. J. Ellsmere
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  6. D. B. Jones
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Corresponding author

Correspondence to M. A. Edwards.

Additional information

Poster Presentation at Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Annual Meeting, Dallas, TX 2006

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Edwards, M.A., Grinbaum, R., Schneider, B.E. et al. Benchmarking hospital outcomes for laparoscopic adjustable gastric banding. Surg Endosc 21, 1950–1956 (2007). https://doi.org/10.1007/s00464-007-9302-0

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  • DOI: https://doi.org/10.1007/s00464-007-9302-0

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