Gastric Banding Research Today is a free monthly online journal that collates and summarizes the latest research about Gastric Banding, including details on laparoscopic gastric banding, stomach stapling, gastric bypass, risks, diet.

Management of failed adjustable gastric banding.

Biertho L, Steffen R, Branson R, Potoczna N, Ricklin T, Piec G, Horber FF

Department of Surgery and Internal Medicine, Hirslanden Clinics, Bern and Zürich, Switzerland.

BACKGROUND: About 100,000 adjustable gastric band placements have been performed worldwide, but more than 10% of patients have needed reoperation for insufficient weight loss or device-related complications. This study investigates the complications following gastric banding, and the outcome using a structured management strategy. METHODS: In the period April 1996 to January 2002, 824 severely obese patients (body mass index 43 +/- 1 kg/m 2 [mean +/- standard error under the mean], age 43 +/- 1 years; 77% women) underwent gastric banding in a single institution and were followed prospectively. Complications, insufficient weight loss, and subsequent management were analyzed. RESULTS: By the fifth treatment year, excess weight loss (EWL) was 54.8 +/- 1.7%; 72.8% of patients lost weight continuously or attained EWL of at least 50%. Insufficient weight loss occurred in 143 patients, and band-related complications occurred in 131 patients, with a mean annual rate of 5.0%. Major reoperation was necessary in 121 patients, and the annual reoperation rate was 4.7%. Following major reoperation, band- and bypass-related complication rates ranged from 6.3% to 11.7% per year. Three deaths occurred, 1 after reoperation and 2 due to preexisting cardiovascular disease. CONCLUSIONS: Applying a structured reoperation algorithm, 5% annual failure after banding was corrected in most patients, and 72.8% of patients attained sufficient weight loss. Reoperation-related mortality was low (.8%), and its annual morbidity was acceptable (4.6%).

Published 22 December 2004 in Surgery, 137(1): 33-41.
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