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Eroded Gastric Band: Where to Next? An Analysis of the Largest Contemporary Series

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Abstract

Purpose

Erosion of a laparoscopic adjustable gastric band (LAGB) is a devastating problem. There is no clear evidence in literature to guide the choice of revisional procedure following an eroded LAGB. The purpose of this study is to analyse the largest series of erosions following LAGB published to-date with an aim to share our experience with this rare complication and how we managed this cohort of patients following explantation of their LAGB.

Materials and Methods

This is a retrospective cohort study. Patient data is maintained prospectively in a surgical database. The study period was from January 1996 to January 2019. The outcomes of patients who underwent an erosion of LAGB were studied.

Results

Gastric band erosion was encountered in 4.7% of patients. Sixty patients opted for a revisional procedure which included 37 repeat LAGBs, 6 laparoscopic sleeve gastrectomies (LSG), 7 Roux-en-Y gastric bypasses (RYGB), 1 intragastric balloon, and 9 failed revisional procedures. Re-erosions were noted in 27% of patients who underwent a repeat gastric banding. Median %TWL at a 1-year follow-up was significantly higher in LSG and RYGB groups compared with that in LAGB (P < 0.008 and P < 0.000, respectively). There was no significant difference between the LSG and RYGB groups.

Conclusion

The risk of re-erosion is increased in patients who undergo repeat AGB following a previous episode of erosion. Repeat LAGB should not be offered after a previous erosion. LSG and RYGB should be considered as appropriate revisional procedures in a patient who experience weight regain following explantation of an eroded LAGB.

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Author information

Author notes

  1. Savio G. Barreto and Jacob Chisholm contributed equally to this work.

Authors and Affiliations

  1. Hepatobiliary and Oesophagogastric Unit, Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia

    Savio G. Barreto, Jacob Chisholm & Lilian Kow

  2. College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia

    Savio G. Barreto, Ann Schloithe & Lilian Kow

  3. Adelaide Bariatric Centre, Flinders Private Hospital, Bedford Park, Adelaide, South Australia, Australia

    Jacob Chisholm, Jane Collins & Lilian Kow

  4. Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Anne-Sophie Mehdorn

Authors
  1. Savio G. Barreto
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  2. Jacob Chisholm
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  3. Anne-Sophie Mehdorn
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  4. Jane Collins
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  5. Ann Schloithe
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  6. Lilian Kow
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Corresponding author

Correspondence to Lilian Kow.

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

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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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Barreto, S.G., Chisholm, J., Mehdorn, AS. et al. Eroded Gastric Band: Where to Next? An Analysis of the Largest Contemporary Series. OBES SURG 30, 2469–2474 (2020). https://doi.org/10.1007/s11695-020-04610-4

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