Systematic review of same-day laparoscopic adjustable gastric band surgery

Laparoscopic adjustable gastric band (LAGB) is the commonest bariatric procedure worldwide. The safety and feasibility of same-day discharge after LAGB has not been reviewed before. The aim of this study is to review the published literature on same-day LAGB. Systematic search was performed in Medline, Embase and Cochrane library using the medical subjects headings terms "ambulatory surgical procedures" and "bariatric surgery" with further free-text search and cross-references. All articles on same-day LAGB which described patient selection criteria, same-day discharge and complications were reviewed. Data were extracted by two independent reviewers. One randomized controlled trial and five cohort studies were included in this review. The patients' age ranged from 18 to 73 years, body mass index ranged from 32.7 to 79 and ASA grade ranged from 1 to 3; 2534 out of 2549 (99.41%) patients could be discharged on the same day. Pain, nausea and dysphagia were the commonest causes for overnight admission. Two out of the six studies reported that 1,982 out of 1984 (99.9%) could be discharged within 23 h; 34 out of 2549 (1.33%) patients developed early complications. No deaths have been reported in these studies. Five out of the six studies mentioned that 12 out of 2,181 patients (0.55%) were readmitted. Dysphagia was the main reason for re-admission. LAGB is safe and feasible as a same-day procedure in selected patients. Early complications and re-admissions are infrequent.