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Small-diameter bands lead to high complication rates in patients after laparoscopic adjustable gastric banding
Juliane Matlach1, Daniela Adolf, Frank Benedix
1Department of General, Visceral and Vascular Surgery, Otto-von-Guericke University of Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany. juliane.matlach@gmx.de
Background:
While weight loss is the primary goal of bariatric procedures, the impact of quality of life (QoL), comorbidity, and surgery-related complications continue to grow. We report on our results of patients up to 12 years of follow-up undergoing laparoscopic adjustable gastric banding (LAGB).
Methods:
Preoperative data of 153 patients treated with LAGB were collected retrospectively. Questionnaires were sent to patients to analyze weight loss, complications, and comorbidities. QoL was assessed using the Bariatric Qualit-of-Life (BQL) questionnaire.
Results:
Of the patients, 83.7% completed the questionnaire. Median follow-up was 8.7 years. Patients were divided into the following groups: Group A (band still in place), group B (band removed), and group C (revision surgery). A significant increase of excess BMI loss (EBL) was found in group A (p<0.0001): EBL was 36.1%, 42.8%, 41.8%, and 37.1% after 1, 3, 5, and 8 years, respectively. Group B showed a significant weight regain after band removal (p=0.007). One hundred ten reoperations were necessary in 67 patients (52.3%): slippage or pouch dilatation in 25.8%, band migration in 3.9%, band intolerance in 6.2%, and 62 revisions due to port complications. According to BQL, a higher EBL correlated with a significantly better assessment of QoL (p<0.0001).
Conclusions:
LAGB resulted in improvement of comorbidities and QoL in banded patients even though not all of them achieved the expected EBL. However, the high complication rate could influence patients' outcome.
