Small-diameter bands lead to high complication rates in patients after laparoscopic adjustable gastric banding

Obes Surg. 2011 Apr;21(4):448-56. doi: 10.1007/s11695-010-0294-9.


Background: While weight loss is the primary goal of bariatric procedures, the impact of quality of life (QoL), comorbidity, and surgery-related complications continue to grow. We report on our results of patients up to 12 years of follow-up undergoing laparoscopic adjustable gastric banding (LAGB).

Methods: Preoperative data of 153 patients treated with LAGB were collected retrospectively. Questionnaires were sent to patients to analyze weight loss, complications, and comorbidities. QoL was assessed using the Bariatric Qualit-of-Life (BQL) questionnaire.

Results: Of the patients, 83.7% completed the questionnaire. Median follow-up was 8.7 years. Patients were divided into the following groups: Group A (band still in place), group B (band removed), and group C (revision surgery). A significant increase of excess BMI loss (EBL) was found in group A (p<0.0001): EBL was 36.1%, 42.8%, 41.8%, and 37.1% after 1, 3, 5, and 8 years, respectively. Group B showed a significant weight regain after band removal (p=0.007). One hundred ten reoperations were necessary in 67 patients (52.3%): slippage or pouch dilatation in 25.8%, band migration in 3.9%, band intolerance in 6.2%, and 62 revisions due to port complications. According to BQL, a higher EBL correlated with a significantly better assessment of QoL (p<0.0001).

Conclusions: LAGB resulted in improvement of comorbidities and QoL in banded patients even though not all of them achieved the expected EBL. However, the high complication rate could influence patients' outcome.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Gastroplasty* / instrumentation
  • Gastroplasty* / methods
  • Humans
  • Intraoperative Complications / epidemiology*
  • Laparoscopy
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology*
  • Quality of Life
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Weight Loss*