Predictors of outcome in treatment of morbid obesity by laparoscopic adjustable gastric banding: results of a prospective study of 380 patients

Surg Obes Relat Dis. Jul-Aug 2008;4(4):500-6. doi: 10.1016/j.soard.2008.03.252. Epub 2008 Jun 30.


Background: We investigated the outcome predictors of laparoscopic gastric banding (LAGB) for morbidly obese patients.

Methods: From December 1996 to November 2004, a total of 380 consecutive unselected patients (78% female; median age 40 yr, range 17-66; body mass index 44.3 kg/m(2), range 35-75) were prospectively evaluated and underwent LAGB. The follow-up rate after a median of 5 years (range 1.5-9.4) was 98%. A survival model was applied, and a multivariate Cox proportional hazard model was used to calculate the hazard ratios for the influential factors.

Results: Of the 380 patients, 128 (33.7%) had their bands removed. Of these 128 patients, 2.4% declined another operation, 18.2% underwent biliopancreatic diversion with duodenal switch, 7.1% underwent laparoscopic Roux-en-Y gastric bypass, and 6% underwent laparoscopic sleeve gastrectomy. The excess weight loss of the remaining 252 patients (66.3%) with a band in situ (including 21 patients after rebanding) was 40%, and only 25% reached an excess weight loss >50%. Older age, binge eating disorder, and sweet-eating behavior were predictors of a poor outcome after LAGB. In contrast, sex, primary body mass index, and co-morbidities had no influence on outcome.

Conclusion: LAGB was less successful in older patients and in patients with binge eating disorder or sweet-eating behavior. These patients might be candidates for a different bariatric procedure.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Body Mass Index
  • Bulimia / complications
  • Feeding Behavior
  • Female
  • Follow-Up Studies
  • Gastroplasty*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Outcome Assessment, Health Care*
  • Prospective Studies
  • Reoperation / statistics & numerical data
  • Weight Loss