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Long-Term Results After Laparoscopic Adjustable Gastric Banding for Morbid Obesity: 18-Year Follow-Up in a Single University Unit

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Abstract

Background

Laparoscopic adjustable gastric banding (LAGB) remains one of the most performed bariatric procedures worldwide, but a few long-term studies have been reported often with limited data at time of longest follow-up. We review our 18-year LAGB experience with special regard to weight loss failure and long-term complications leading to band removal.

Methods

We performed 897 LAGB procedures from April 1996 to December 2007: 376 using the perigastric dissection and 521 using the pars flaccida dissection. We performed a retrospective analysis of the data of this consecutive series. Failure was defined as band removal with or without conversion to another procedure or excess weight loss (EWL%) <25 %.

Results

There were 120 men and 770 women. Mean age was 39.5 years, and mean BMI was 45.6 kg/m2. Mean follow-up was 14.6 years (range 101–228 months) with 90 % follow-up beyond 10 years. Ten (1.1 %) had early complications and 504 (56 %) late complications. Overall, 374 (41.6 %) bands were explanted for complications, weight regain, or intolerance. Mean 15-year EWL% in patients with band in place was 41.73 %. Over time, band failure rate increases from 18.4 % at 2 years to 43 % at 10 years and more than 70 % beyond 15 years.

Conclusions

Despite good initial results, late complications, weight regain, and intolerance lead to band removal in nearly half of the patients over time. However, given that there is no good information on alternative procedures in the long term and considering its reversibility and safety still has a place in the treatment of morbid obesity for informed and motivated patients.

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References

  1. Belachew M, Legrand M, Vincenti VV, Deffechereux T, Jourdan JL, Monami B, Jacquet N. Laparoscopic placement of adjustable silicone gastric band in the treatment of morbid obesity: how to do it. Obes Surg. 1995;5(1):66–70.

    Article  CAS  PubMed  Google Scholar 

  2. Fielding GA, Rhodes M, Nathanson LK. Laparoscopic gastric banding for morbid obesity. Surgical outcome in 335 cases. Surg Endosc. 1999;13(6):550–4.

    Article  CAS  PubMed  Google Scholar 

  3. Miller K, Pump A, Hell E. Vertical banded gastroplasty versus adjustable gastric banding: prospective long-term follow-up study. Surg Obes Relat Dis. 2007;3(1):84–90.

    Article  PubMed  Google Scholar 

  4. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  5. Parikh MS, Fielding GA, Ren CJ. U.S. experience with 749 laparoscopic adjustable gastric bands: intermediate outcomes. Surg Endosc. 2005;19(12):1631–5.

    Article  CAS  PubMed  Google Scholar 

  6. Angrisani L, Furbetta F, Doldi SB, Basso N, Lucchese M, Giacomelli F, Zappa M, Di Cosmo L, Veneziani A, Turicchia GU, et al. Lap Band adjustable gastric banding system: the Italian experience with 1863 patients operated on 6 years. Surg Endosc. 2003;17(3):409–12.

    Article  CAS  PubMed  Google Scholar 

  7. Weiner R, Blanco-Engert R, Weiner S, Matkowitz R, Schaefer L, Pomhoff I. Outcome after laparoscopic adjustable gastric banding—8 years experience. Obes Surg. 2003;13(3):427–34.

    Article  CAS  PubMed  Google Scholar 

  8. Chevallier JM, Zinzindohoue F, Douard R, Blanche JP, Berta JL, Altman JJ, Cugnenc PH. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg. 2004;14(3):407–14.

    Article  PubMed  Google Scholar 

  9. Favretti F, Segato G, Ashton D, Busetto L, De Luca M, Mazza M, Ceoloni A, Banzato O, Calo E, Enzi G. Laparoscopic adjustable gastric banding in 1,791 consecutive obese patients: 12-year results. Obes Surg. 2007;17(2):168–75.

    Article  PubMed  Google Scholar 

  10. Naef M, Mouton WG, Naef U, Kummer O, Muggli B, Wagner HE. Graft survival and complications after laparoscopic gastric banding for morbid obesity—lessons learned from a 12-year experience. Obes Surg. 2010;20(9):1206–14.

    Article  PubMed  Google Scholar 

  11. Lanthaler M, Aigner F, Kinzl J, Sieb M, Cakar-Beck F, Nehoda H. Long-term results and complications following adjustable gastric banding. Obes Surg. 2010;20(8):1078–85.

    Article  PubMed  Google Scholar 

  12. Stroh C, Hohmann U, Schramm H, Meyer F, Manger T. Fourteen-year long-term results after gastric banding. J Obes. 2011;2011:128451.

    Article  PubMed  Google Scholar 

  13. Favretti F, Ashton D, Busetto L, Segato G, De Luca M. The gastric band: first-choice procedure for obesity surgery. World J Surg. 2009;33(10):2039–48.

    Article  PubMed  Google Scholar 

  14. O'Brien PE, MacDonald L, Anderson M, Brennan L, Brown WA. 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. 2013;257(1):87–94.

    Article  PubMed  Google Scholar 

  15. Aarts EO, Dogan K, Koehestanie P, Aufenacker TJ, Janssen IM, Berends FJ. Long-term results after laparoscopic adjustable gastric banding: a mean fourteen year follow-up study. Surg Obes Relat Dis. 2014;10(4):633–40.

    Article  CAS  PubMed  Google Scholar 

  16. Toolabi K, Golzarand M, Farid R: Laparoscopic adjustable gastric banding: efficacy and consequences over a 13-year period. Am J Surg 2015.

  17. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  PubMed  Google Scholar 

  18. Reinhold RB. Critical analysis of long term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155(3):385–94.

    CAS  PubMed  Google Scholar 

  19. Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  20. O'Brien PE, McPhail T, Chaston TB, Dixon JB. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16(8):1032–40.

    Article  PubMed  Google Scholar 

  21. Mittermair RP, Obermuller S, Perathoner A, Sieb M, Aigner F, Margreiter R. Results and complications after Swedish adjustable gastric banding-10 years experience. Obes Surg. 2009;19(12):1636–41.

    Article  PubMed  Google Scholar 

  22. Shen X, Zhang X, Bi J, Yin K. Long-term complications requiring reoperations after laparoscopic adjustable gastric banding: a systematic review. Surg Obes Relat Dis. 2015;11(4):956–64.

    Article  PubMed  Google Scholar 

  23. Angrisani L, Cutolo PP, Formisano G, Nosso G, Vitolo G. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surg Obes Relat Dis. 2013;9(3):405–13.

    Article  PubMed  Google Scholar 

  24. Suter M, Calmes JM, Paroz A, Giusti V. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg. 2006;16(7):829–35.

    Article  CAS  PubMed  Google Scholar 

  25. Kindel T, Martin E, Hungness E, Nagle A. High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surg Obes Relat Dis. 2014;10(6):1070–5.

    Article  PubMed  Google Scholar 

  26. Brown JJ, Boyle M, Mahawar K, Balupuri S, Small PK. Laparoscopic adjustable gastric band survival in a high-volume bariatric unit. Br J Surg. 2013;100(12):1614–8.

    Article  CAS  PubMed  Google Scholar 

  27. Scozzari G, Farinella E, Bonnet G, Toppino M, Morino M. Laparoscopic adjustable silicone gastric banding vs laparoscopic vertical banded gastroplasty in morbidly obese patients: long-term results of a prospective randomized controlled clinical trial. Obes Surg. 2009;19(8):1108–15.

    Article  PubMed  Google Scholar 

  28. O'Brien PE, Dixon JB, Laurie C, Anderson M. A prospective randomized trial of placement of the laparoscopic adjustable gastric band: comparison of the perigastric and pars flaccida pathways. Obes Surg. 2005;15(6):820–6.

    Article  PubMed  Google Scholar 

  29. 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.

    Article  CAS  PubMed  Google Scholar 

  30. te Riele WW, van Santvoort HC, Boerma D, van Westreenen HL, Wiezer MJ, van Ramshorst B. Rebanding for slippage after gastric banding: should we do it? Obes Surg. 2014;24(4):588–93.

    Article  Google Scholar 

  31. Muller MK, Attigah N, Wildi S, Hahnloser D, Hauser R, Clavien PA, Weber M. High secondary failure rate of rebanding after failed gastric banding. Surg Endosc. 2008;22(2):448–53.

    Article  CAS  PubMed  Google Scholar 

  32. Mognol P, Chosidow D, Marmuse JP. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding in the super-obese: a comparative study of 290 patients. Obes Surg. 2005;15(1):76–81.

    Article  PubMed  Google Scholar 

  33. Carlin AM, Zeni TM, English WJ, Hawasli AA, Genaw JA, Krause KR, Schram JL, Kole KL, Finks JF, Birkmeyer JD, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Ann Surg. 2013;257(5):791–7.

    Article  PubMed  Google Scholar 

  34. Romy S, Donadini A, Giusti V, Suter M. Roux-en-Y gastric bypass vs gastric banding for morbid obesity: a case-matched study of 442 patients. Arch Surg. 2012;147(5):460–6.

    Article  PubMed  Google Scholar 

  35. Nguyen NT, Slone JA, Nguyen XM, Hartman JS, Hoyt DB. A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic adjustable gastric banding for the treatment of morbid obesity: outcomes, quality of life, and costs. Ann Surg. 2009;250(4):631–41.

    PubMed  Google Scholar 

  36. Snyder B, Nguyen A, Scarbourough T, Yu S, Wilson E. Comparison of those who succeed in losing significant excessive weight after bariatric surgery and those who fail. Surg Endosc. 2009;23(10):2302–6.

    Article  PubMed  Google Scholar 

  37. Arapis K, Chosidow D, Lehmann M, Bado A, Polanco M, Kamoun-Zana S, Pelletier AL, Kousouri M, Marmuse JP. Long-term results of adjustable gastric banding in a cohort of 186 super-obese patients with a BMI>/= 50 kg/m2. J Visc Surg. 2012;149(2):e143–52.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of General and Visceral Surgery, Bichat-Claude Bernard University Hospital, Paris, France

    K. Arapis, P. Tammaro, L. Ribeiro Parenti, D. Chosidow, M. Kousouri & J.P. Marmuse

  2. Department of Hepato-Gastroenterology, Bichat-Claude Bernard University Hospital, Paris, France

    A.L. Pelletier

  3. Team REGLYS University of Paris-CNRS, UMR8251, Paris, France

    C. Magnan

  4. Team of Diabetes Vascular Complication Cordelier Recherche Center, Department of Diabetes and Nutrition Bichat-Claude Bernard University Hospital, Paris, France

    B. Hansel

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  1. K. Arapis
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  2. P. Tammaro
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Correspondence to K. Arapis.

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The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Arapis, K., Tammaro, P., Parenti, L.R. et al. Long-Term Results After Laparoscopic Adjustable Gastric Banding for Morbid Obesity: 18-Year Follow-Up in a Single University Unit. OBES SURG 27, 630–640 (2017). https://doi.org/10.1007/s11695-016-2309-7

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  • DOI: https://doi.org/10.1007/s11695-016-2309-7

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