BACKGROUND: We investigated the success rate of a two-stage operative concept for treatment of morbid obesity: primary laparoscopic adjustable gastric banding (LAGB, Lap-Band) for all morbidly obese patients, followed by sleeve gastrectomy with biliopancreatic diversion (duodenal switch or DS) in case of failure. METHODS: From Dec 1996 to May 2004, 366 consecutive patients (female 78%, mean age 41 (17-66) years, BMI 44.3 (35-75) kg/m2 were prospectively evaluated, using the two-stage operative concept. The follow-up rate after a mean of 4.1 (1-8.4) years was 98%. Primary outcome measure was BAROS score, defined according to weight loss, quality of life, reduction in co-morbidities, complications and re-operations. RESULTS: A very good-to-excellent result was found in 118 patients (32%), 141 (39%) had a good results, 76 (21%) a fair result, and 31 (8%) were failures. 39 patients needed re-banding due to slippage, 68 a DS, and 11 patients had band removal. Early morbidity of the Lap-Band was 3.8%, that of DS 13%, and mortality was zero. The excess weight loss at last follow-up of all the patients was 44% (40% after Lap-Band/rebanding, and 82% 2 years after DS). CONCLUSION: The two-stage concept with primary LAGB, followed by DS in case of failure, leads to a good result in 71% of morbidly obese patients. LAGB alone does not appear to be an adequate procedure for every morbidly obese patient.
BACKGROUND: We investigated the success rate of a two-stage operative concept for treatment of morbid obesity: primary laparoscopic adjustable gastric banding (LAGB, Lap-Band) for all morbidly obese patients, followed by sleeve gastrectomy with biliopancreatic diversion (duodenal switch or DS) in case of failure. METHODS: From Dec 1996 to May 2004, 366 consecutive patients (female 78%, mean age 41 (17-66) years, BMI 44.3 (35-75) kg/m2 were prospectively evaluated, using the two-stage operative concept. The follow-up rate after a mean of 4.1 (1-8.4) years was 98%. Primary outcome measure was BAROS score, defined according to weight loss, quality of life, reduction in co-morbidities, complications and re-operations. RESULTS: A very good-to-excellent result was found in 118 patients (32%), 141 (39%) had a good results, 76 (21%) a fair result, and 31 (8%) were failures. 39 patients needed re-banding due to slippage, 68 a DS, and 11 patients had band removal. Early morbidity of the Lap-Band was 3.8%, that of DS 13%, and mortality was zero. The excess weight loss at last follow-up of all the patients was 44% (40% after Lap-Band/rebanding, and 82% 2 years after DS). CONCLUSION: The two-stage concept with primary LAGB, followed by DS in case of failure, leads to a good result in 71% of morbidly obese patients. LAGB alone does not appear to be an adequate procedure for every morbidly obese patient.
Authors: Laurent Biertho; Rudolf Steffen; Ruth Branson; Natascha Potoczna; Thomas Ricklin; Grazyna Piec; Fritz F Horber Journal: Surgery Date: 2005-01 Impact factor: 3.982
Authors: Melinda A Maggard; Lisa R Shugarman; Marika Suttorp; Margaret Maglione; Harvey J Sugerman; Harvey J Sugarman; Edward H Livingston; Ninh T Nguyen; Zhaoping Li; Walter A Mojica; Lara Hilton; Shannon Rhodes; Sally C Morton; Paul G Shekelle Journal: Ann Intern Med Date: 2005-04-05 Impact factor: 25.391
Authors: Ruth Branson; Natascha Potoczna; John G Kral; Klaus-Ulrich Lentes; Margret R Hoehe; Fritz F Horber Journal: N Engl J Med Date: 2003-03-20 Impact factor: 91.245
Authors: Nicolas V Christou; John S Sampalis; Moishe Liberman; Didier Look; Stephane Auger; Alexander P H McLean; Lloyd D MacLean Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
Authors: Andrea Lindinger; Ralph Peterli; Thomas Peters; Beatrice Kern; Markus von Flüe; Martine Calame; Matthias Hoch; Alex N Eberle; Peter W Lindinger Journal: Obes Surg Date: 2009-10-14 Impact factor: 4.129