Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 82 (1), 18-27

Early Experience With Diagnosis and Management of Eroded Gastric Bands

Affiliations

Early Experience With Diagnosis and Management of Eroded Gastric Bands

Chang Ik Yoon et al. J Korean Surg Soc.

Abstract

Purpose: Band erosion is a well-known complication of laparoscopic adjustable gastric band placement. We gained experience with laparoscopic removal of an eroded gastric band.

Methods: We retrospectively reviewed the operative log of our obesity surgery unit to identify all operations performed for band erosion from March 2009 to May 2011.

Results: During the study period, a total of six of 96 patients (6.3%), five females and one male, were diagnosed with band erosion and underwent surgical removal of the band system. The median time interval from the initial gastric band placement to the diagnosis of band erosion was 8.5 months (range, 7 to 22 months), with most band erosion occurring within the first year (5/6, 83%). The median body mass index at band removal was 28.4 kg/m(2). Upper abdominal pain was the most common symptom (5/6, 83%), and other signs and symptoms were port site infection (3/6, 50%) and loss of restriction and weight regain (1/6, 17%). All eroded bands were removed using laparoscopy. Further complications after laparoscopic removal of the band system were observed in three cases. One patient showed multiple intra-abdominal abscesses requiring insertion of a pigtail catheter for drainage. The other two patients experienced sepsis with localized peritonitis, eventually requiring laparoscopic washout and drainage.

Conclusion: Gastric band erosion requires the removal of the gastric band. Laparoscopic removal is technically achievable in the majority of patients with eroded gastric band. The method can be challenging, has potential postoperative complications (fistula, abscess), and should be attempted only by experienced surgeons.

Keywords: Band erosion; Bariatric surgery; Complications; Gastric banding; Morbid obesity.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Flow chart showing the diagnosis procedure in patients with band erosion (BE). UGI, upper gastrointestinal; CT, computed tomography; EGD, esophagogastroduodenoscopy.
Fig. 2
Fig. 2
Location of band erosion on esophagogastroduodenoscopy. 1, anterosuperior; 2, posterosuperior; 3, anteroinferior; 4, posteroinferior.
Fig. 3
Fig. 3
(A) Five days after band removal, the patient (#4) showed localized peritonitis in the right lower quadrant (RLQ) abdomen. Abdominal computed tomopgraphy (CT) scan showed multifocal, loculated, and encapsulated fluid collection in the RLQ (diameter: 6.5 cm) (arrow). (B) Third days after band removal, the patient (#6) showed a spiking fever, tachycardia, and left pleuritic chest pain. Abdominal CT scan showed a suspicious perigastric abscess near the suture line and loculated fluid collections or abscess indenting anterior surface of the left lateral segment of liver (long arrows). A closed-suction drain was located in the subhepatic space (short arrows).

Similar articles

See all similar articles

Cited by 6 PubMed Central articles

See all "Cited by" articles

References

    1. Cunneen SA, Phillips E, Fielding G, Banel D, Estok R, Fahrbach K, et al. Studies of Swedish adjustable gastric band and Lap-Band: systematic review and meta-analysis. Surg Obes Relat Dis. 2008;4:174–185. - PubMed
    1. O'Brien PE, Brown WA, Smith A, McMurrick PJ, Stephens M. Prospective study of a laparoscopically placed, adjustable gastric band in the treatment of morbid obesity. Br J Surg. 1999;86:113–118. - PubMed
    1. Favretti F, Enzi G, Pizzirani E, Segato G, Belluco C, Pigato P, et al. Adjustable silicone gastric banding (ASGB): the Italian experience. Obes Surg. 1993;3:53–56. - PubMed
    1. Parikh MS, Fielding GA, Ren CJ. U.S. experience with 749 laparoscopic adjustable gastric bands: intermediate outcomes. Surg Endosc. 2005;19:1631–1635. - PubMed
    1. Vertruyen M. Experience with Lap-band System up to 7 years. Obes Surg. 2002;12:569–572. - PubMed
Feedback