A study examining the complications associated with gastric banding.

BACKGROUND: Gastric banding is a well-recognized and common method of weight reduction surgery. Between November 2001 and September 2011, 1,100 laparoscopic adjustable gastric banding operations were performed in Sheffield. This study examines the long-term complication rate.
METHODS: All available medical notes for patients undergoing gastric banding by one surgeon were reviewed. Data were available for 1,079 patients.
RESULTS: A total of 932 females and 147 males underwent gastric banding. Mean weight was 120 kg, with body mass index of 43.3. Complications occurred in 347 patients (32.1 %). One hundred three (13.2 %) patients experienced band slippage; re-operation was required in half of these cases. Eighty-two patients had their band removed due to complications; there was slippage in 60, erosion in 17, and band intolerance in 5. One hundred thirty-six (12.6 %) patients experienced problems with their port or port tubing. Thirty-seven ports were flipped, noted during clinical or radiological fills (3.4 %), and 17 patients experienced port infection (1.5 %). Fifty ports required repositioning (4.6 %); 16 (1.4 %) were removed or replaced including five for cutaneous erosion. Eleven patients experienced tubing problems. Four patients required procedures to deal with intraoperative complications. Eighteen patients had a concurrent procedure. One postoperative death was due to biliary peritonitis in a patient who had undergone simultaneous cholecystectomy.
CONCLUSION: Complication rates reflect those in the literature. Slippage rate may appear higher in our patients, but this is a reflection of the fact that most patients undergo radiological band fills; hence, many non-symptomatic slippages are detected. Only half of our slippages (6.6 % of all patients) were clinically apparent or needed any intervention.