Ramsey M Dallal1, Linda Bailey. 1. Division of Bariatric Surgery, Albert Einstein Healthcare Network, Philadelphia, Pa, USA. dallalr@einstein.edu
Abstract
BACKGROUND: The laparoscopic adjustable gastric band (LAGB) has been offered as a safe, effective, and reversible alternative to more invasive weight loss procedures. METHODS: All LAGB procedures performed from May 2001 to July 2005 were reviewed retrospectively with respect to complications and weight loss. RESULTS: During this time period, 186 LAGBs were placed. Average body mass index (BMI) was 43.5 kg/m2 (range, 32 to 62 kg/m2). Average age was 47.8 years (range, 18 to 76 years). Females constituted 76% of patients. Average duration of follow-up was 26.1 months, with follow-up at 1, 2, and 3 years of 96%, 76%, and 62% of patients, respectively. Average number of postoperative office visits was 11. At 1, 2, and 3 years, excess weight loss was 36%, 42%, and 42%, respectively. Of the patients, 30% did not lose more than 25% of their excess weight, and 54% did not achieve a BMI less than 35 kg/m2. The only measured predictor of improved weight loss was lower initial weight (P < .0005). The independent variables, surgeon, surgeon experience, patient age, height and sex were not predictive. Mortality rate was zero. 113 complications developed in 87 patients (47%). The 30-day re-operation rate was 2% and the overall re-operation rate was 33%. However, eliminating patients who had the older Taper I port and only examining patients with the newer Taper II port, overall complication and re-operation rates decreased to 32% and 17%, respectively. Persistent esophageal complications occurred in 16 patients (8.6%); 5 patients developed pouch dilation, and 4 developed prolapse. A total of 13 (7%) LAGBs were explanted, and 9 patients were converted to a gastric bypass. CONCLUSION: The LAGB procedure resulted in variable weight loss and a substantial number of complications.
BACKGROUND: The laparoscopic adjustable gastric band (LAGB) has been offered as a safe, effective, and reversible alternative to more invasive weight loss procedures. METHODS: All LAGB procedures performed from May 2001 to July 2005 were reviewed retrospectively with respect to complications and weight loss. RESULTS: During this time period, 186 LAGBs were placed. Average body mass index (BMI) was 43.5 kg/m2 (range, 32 to 62 kg/m2). Average age was 47.8 years (range, 18 to 76 years). Females constituted 76% of patients. Average duration of follow-up was 26.1 months, with follow-up at 1, 2, and 3 years of 96%, 76%, and 62% of patients, respectively. Average number of postoperative office visits was 11. At 1, 2, and 3 years, excess weight loss was 36%, 42%, and 42%, respectively. Of the patients, 30% did not lose more than 25% of their excess weight, and 54% did not achieve a BMI less than 35 kg/m2. The only measured predictor of improved weight loss was lower initial weight (P < .0005). The independent variables, surgeon, surgeon experience, patient age, height and sex were not predictive. Mortality rate was zero. 113 complications developed in 87 patients (47%). The 30-day re-operation rate was 2% and the overall re-operation rate was 33%. However, eliminating patients who had the older Taper I port and only examining patients with the newer Taper II port, overall complication and re-operation rates decreased to 32% and 17%, respectively. Persistent esophageal complications occurred in 16 patients (8.6%); 5 patients developed pouch dilation, and 4 developed prolapse. A total of 13 (7%) LAGBs were explanted, and 9 patients were converted to a gastric bypass. CONCLUSION: The LAGB procedure resulted in variable weight loss and a substantial number of complications.