Very Long-Term Outcomes of Laparoscopic Adjustable Gastric Banding in a Japanese Cohort: A Single-Center 15-Year...

The long-term clinical role of laparoscopic adjustable gastric banding (LAGB) remains uncertain in the contemporary era of metabolic surgery, and very long-term outcome data from Asian populations are limited. This study evaluated very long-term outcomes of LAGB in a Japanese cohort, focusing on weight change, metabolic comorbidities, and reoperations.

We retrospectively reviewed consecutive patients who underwent LAGB between 2005 and 2010 at a single institution. Changes in body weight, metabolic comorbidities, and reoperation were assessed for up to 15 years. Weight outcomes were evaluated using percent total weight loss (%TWL) and percent excess weight loss (%EWL).

A total of 28 patients were included. Mean %EWL was 49% at 1 year, 62% at 5 years, 64% at 10 years, and 59% at 15 years, indicating sustained long-term weight reduction despite partial weight regain. Early improvements in metabolic comorbidities were observed; however, recurrence of diabetes mellitus, hypertension, and dyslipidemia increased after 5-10 years, whereas hepatic comorbidities remained relatively stable. Reoperation was required in 7 of 28 patients (25%), mainly because of device-related complications or insufficient weight loss.

This study provides very long-term outcome data of LAGB in an Asian cohort. Although LAGB achieved sustained weight reduction in selected patients, metabolic improvements showed limited long-term durability and a substantial proportion of patients required reoperation. These findings highlight the limitations of a purely restrictive and device-dependent bariatric procedure in the contemporary era of metabolic surgery.