Long-term outcomes of gastric band removal without additional bariatric surgery

The outcomes of patients undergoing band removal alone without an additional bariatric procedure after laparoscopic gastric banding are not well reported. We seek to close this gap in the literature.

Cantonal Hospital & University Teaching Hospital, Switzerland METHODS: In this retrospective study, we investigated 21 patients who underwent band removal with a mean follow-up of 63 months. Weight regain, co-morbidities, and quality of life were assessed.

The laparoscopic gastric bandings were implanted at a mean initial body mass index (BMI) of 44.6 kg/m². The bands remained in situ for an average of 87.7 months (range: 14-185 mo). The reasons for band removal included band slippage in 9 cases (42.9%), band penetration in 6 cases (28.6%), leakage, port infection, and patient request in 2 cases (9.5% each). The average BMI at the time of band removal was 34.9 kg/m². At 62.9 months after band removal, patients regained an average of 17.3 kg and attained a mean BMI of 41.0 kg/m². Co-morbidities such as type 2 diabetes, arterial hypertension, obstructive sleep apnea, and psychiatric disorders worsened during the follow-up period. Thirteen of 21 patients rated their quality of life as bad, 5 as mediocre, and only 3 as good. Only 2 patients said they would undergo a gastric banding procedure again. The patients achieved an average of-.6 points on the Moorehead-Ardelt quality of life score, which indicates a fair quality of life.

This study finds that reversal of gastric banding procedures with removal of the banding system alone leads to weight regain, deterioration of physical and psychiatric co-morbidities, and low quality of life scores.