Authors: Fielding, George; Duncombe, Jennifer

Source: Obesity Surgery, Volume 15, Number 5, May 2005 , pp. 634-640(7)

Publisher: Springer

Abstract:

Background: Concerns still exist about the long-term effectiveness and rate of retention of the laparoscopic adjustable gastric band (LAGB). Furthermore, esophageal dilatation has been suggested as a long-term complication for LAGB. We therefore sought to objectively analyze our follow-up results in patients with LAGB performed in 1998 by perigastric technique and 2000 by pars flaccida technique. We also offered patients for 1998 a barium esophagram to assess dilatation. Methods: Data on all 2,300 LAGBs performed since 1996 have been prospectively collected in LapBase. This data was accessed for 1998 and 2000, for follow-up complication, band removal, weight loss and comorbidity reduction. Patients were offered barium esophagrams. Results: 123 patients (mean weight 127 kg, mean BMI 44.5 kg/m²) had LAGB in 1998, and 162 patients (mean weight 123 kg, mean BMI 44) had LAGB in 2000. Follow-up was a mean 67 months in 88% for 1998 and 94% at 34 months for 2000. Mean %EWL for 1998 was 51.2% with mean BMI 31.9. Slippage occurred in 9.5% in 1998 compared to 4.3% in 2000 (P<0.01). 20 of 23 diabetics are off all treatment. 1 of 34 patients had esophageal dilatation on barium esophagram, which resolved on band deflation. Conclusion: LAGB is a safe and effective at midterm follow-up. Less slippage occurred after the pars flaccida technique. No evidence of permanent esophageal dilatation was found on barium studies.

Keywords: MORBID OBESITY; LAPAROSCOPIC GASTRIC BANDING; SURGICAL TECHNIQUE; FOLLOW-UP; ESOPHAGEAL DILATATION

Document Type: Research article

DOI: http://dx.doi.org/10.1381/0960892053923879

Publication date: 2005-05-01

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