Results and complications after Swedish adjustable gastric banding-10 years experience

Bariatric surgery is currently the only effective treatment for morbid obesity. The main advantage of laparoscopic adjustable gastric banding is that this operation is minimally invasive to the stomach and adjustable to the patient's needs. Few long-term studies on Swedish adjustable gastric banding (SAGB) have been published. We here report our 10-year experience with 785 SAGB procedures.

Between January 1996 and January 2006, 785 consecutive patients (81% women, 19% men) underwent laparoscopic SAGB. All data (demographic and morphologic, operative, and annual follow-up data) were prospectively collected in a computerized data bank. The postoperative follow-up program was performed largely by residents while 30 different surgeons performed the operation.

Follow up data were available for 733 patients (98.3%); 52 patients (6.6%) were lost to follow-up. The median follow-up was 3.0 years (range, 1-10 years). The median total weight loss was 26 kg after 1 year and 40.5 kg after 8 years with a median EWL of 65.5% after 8 years. The median BMI decreased from 42.9 to 28.3 kg/m2. A total number of 688 complications occurred in 396 patients (50.4%). The most common complications were esophagitis (28.8%), pouch dilation (15.3%), esophageal dilation (12.5%), port problems (11%), band migration (6.5%), and band leakage (6.4%). Overall, 251 reoperations (32%) were performed. There was no mortality.

From our 10-year experience, we can state that SAGB is an effective bariatric procedure for achieving weight loss. Because of the high complication and reoperation rate, it is necessary to select patients according to specific criteria for gastric banding.