BACKGROUND: About 100,000 adjustable gastric band placements have been performed worldwide, but more than 10% of patients have needed reoperation for insufficient weight loss or device-related complications. This study investigates the complications following gastric banding, and the outcome using a structured management strategy. METHODS: In the period April 1996 to January 2002, 824 severely obese patients (body mass index 43 +/- 1 kg/m 2 [mean +/- standard error under the mean], age 43 +/- 1 years; 77% women) underwent gastric banding in a single institution and were followed prospectively. Complications, insufficient weight loss, and subsequent management were analyzed. RESULTS: By the fifth treatment year, excess weight loss (EWL) was 54.8 +/- 1.7%; 72.8% of patients lost weight continuously or attained EWL of at least 50%. Insufficient weight loss occurred in 143 patients, and band-related complications occurred in 131 patients, with a mean annual rate of 5.0%. Major reoperation was necessary in 121 patients, and the annual reoperation rate was 4.7%. Following major reoperation, band- and bypass-related complication rates ranged from 6.3% to 11.7% per year. Three deaths occurred, 1 after reoperation and 2 due to preexisting cardiovascular disease. CONCLUSIONS: Applying a structured reoperation algorithm, 5% annual failure after banding was corrected in most patients, and 72.8% of patients attained sufficient weight loss. Reoperation-related mortality was low (.8%), and its annual morbidity was acceptable (4.6%).
BACKGROUND: About 100,000 adjustable gastric band placements have been performed worldwide, but more than 10% of patients have needed reoperation for insufficient weight loss or device-related complications. This study investigates the complications following gastric banding, and the outcome using a structured management strategy. METHODS: In the period April 1996 to January 2002, 824 severely obesepatients (body mass index 43 +/- 1 kg/m 2 [mean +/- standard error under the mean], age 43 +/- 1 years; 77% women) underwent gastric banding in a single institution and were followed prospectively. Complications, insufficient weight loss, and subsequent management were analyzed. RESULTS: By the fifth treatment year, excess weight loss (EWL) was 54.8 +/- 1.7%; 72.8% of patients lost weight continuously or attained EWL of at least 50%. Insufficient weight loss occurred in 143 patients, and band-related complications occurred in 131 patients, with a mean annual rate of 5.0%. Major reoperation was necessary in 121 patients, and the annual reoperation rate was 4.7%. Following major reoperation, band- and bypass-related complication rates ranged from 6.3% to 11.7% per year. Three deaths occurred, 1 after reoperation and 2 due to preexisting cardiovascular disease. CONCLUSIONS: Applying a structured reoperation algorithm, 5% annual failure after banding was corrected in most patients, and 72.8% of patients attained sufficient weight loss. Reoperation-related mortality was low (.8%), and its annual morbidity was acceptable (4.6%).
Authors: Michael D Jensen; Donna H Ryan; Caroline M Apovian; Jamy D Ard; Anthony G Comuzzie; Karen A Donato; Frank B Hu; Van S Hubbard; John M Jakicic; Robert F Kushner; Catherine M Loria; Barbara E Millen; Cathy A Nonas; F Xavier Pi-Sunyer; June Stevens; Victor J Stevens; Thomas A Wadden; Bruce M Wolfe; Susan Z Yanovski; Harmon S Jordan; Karima A Kendall; Linda J Lux; Roycelynn Mentor-Marcel; Laura C Morgan; Michael G Trisolini; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: Roshani Vijaykumar Patel; Patrick Woodburn; James R A Skipworth; William James Buchanan Smellie Journal: Obes Surg Date: 2018-05 Impact factor: 4.129