Is it possible to improve long-term results of laparoscopic adjustable gastric banding with appropriate patient selection?

Michał Orłowski; Michał Janik; Paula Franczak; Agata Frask; Maciej Michalik

doi:10.5114/wiitm.2019.86773

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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abstract:

Original paper

Is it possible to improve long-term results of laparoscopic adjustable gastric banding with appropriate patient selection?

Michał Orłowski

¹

,

Michał Janik

²

,

Paula Franczak

¹

,

Agata Frask

¹

,

Maciej Michalik

³

Department of General and Oncological Surgery, Ceynowa Hospital, Wejherowo, Poland
Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury, Olsztyn, Poland

Videosurgery Miniinv 2020; 15 (1): 166–170

DOI: https://doi.org/10.5114/wiitm.2019.86773

Online publish date: 2019/07/22

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Introduction
The gastric band is still offered as a good bariatric option for highly motivated and carefully selected patients. The question is whether this faith is justified or not.

Aim
To assess long-term clinical outcomes of patients who underwent laparoscopic adjustable gastric banding (LAGB) at a single bariatric center and to examine variables associated with patients’ adherence to scheduled postoperative appointments.

Material and methods
A retrospective review of patients who underwent LAGB between 2004 and 2009 was performed. The initial cohort included 167 patients. Data regarding sex, age, preoperative weight, hometown population and distance from the bariatric center, and gastric band volume were collected. Compliance was measured as the number of postoperative appointments. Clinical outcome was defined as percent excess weight loss (%EWL) at the end of the observation period or at band removal.

Results
The LAGB was performed in 167 patients between 2004 and 2009. The mean follow-up time was 90 ±24 months. Five (3%) patients were lost to follow-up; 37 (22.2%) had their band removed. The remaining 125 (74.8%) patients retained their bands and were included in the analysis. The mean %EWL was 33.0 ±26.6%. Thirty-one (18.6%) patients achieved %EWL > 50%.

Conclusions
This study found that LAGB was not an effective bariatric procedure in long-term observation. Only 25% of 125 patients who maintained a functioning band achieved %EWL > 50%. Compliance was the only independent prognostic factor for weight loss. Other factors had no influence on outcome.

keywords:

Is it possible to improve long-term results of laparoscopic adjustable gastric banding with appropriate patient selection?

Michał Orłowski 1 , Michał Janik 2 , Paula Franczak 1 , Agata Frask 1 , Maciej Michalik 3

bariatric surgery, laparoscopy, long-term follow-up, laparoscopic adjustable gastric banding, gastric band

Michał Orłowski

¹

,

Michał Janik

²

,

Paula Franczak

¹

,

Agata Frask

¹

,

Maciej Michalik

³