Results and complications after Swedish adjustable gastric banding in older patients.

BACKGROUND: Swedish adjustable gastric banding (SAGB) is an effective treatment for morbid obesity. The aim of this study was to assess the efficacy and safety of SAGB in older patients aged >or=50 years.
METHODS: Between January 1996 and January 2006, 134 patients (102 women, 32 men) of 785 consecutive patients who underwent SAGB during the study period were aged >or=50 years. Two groups of patients were analyzed: Group 50 (n=107) patients aged 50-59 years and Group 60 (n=27) patients aged 60-69 years. All data (demographic and morphologic data, operative data, and follow-up data) were prospectively collected in a computerized databank.
RESULTS: One hundred thirty-four patients (17.1%) out of 785 entered the study. Mean percentage of excess weight loss (%EWL) was 37.5 at 1 year and 48.8 at 7 years, body mass index (BMI) fell from 43.3 to 33.1 at 7 years. In the 134 patients, there were 65 patients with 121 complications (48.5%) and 69 patients with no complication (51.5%). The most common complications were esophagitis (27%), esophageal dilation (16%), port problems (11%), pouch dilation (11%), band leakage (9%), and band migration (7%). Overall, 46 patients (34%) needed a reoperation. In Group 50, mean %EWL was 38.4 at 1 year and 54.9 at 7 years. BMI fell from 42.9 to 33.1 at 7 years. In the 107 patients, there were 55 patients with 99 complications (51%) and a reoperation rate of 35.5%. In Group 60, mean %EWL was 32.8 at 1 year and 41.2 at 7 years. BMI fell from 44.3 to 34 at 7 years. In the 27 patients, there were ten patients with 22 complications (37%) and a reoperation rate of 29.6%. There was no mortality.
CONCLUSIONS: At 7-year follow-up, for older patients, SAGB is an effective bariatric procedure for achieving weight loss. Nevertheless, based on the high complication and reoperation rate, a gastric band-specific patient selection will be necessary.