Adjustable gastric banding in a public university hospital: prospective analysis of 400 patients.
BACKGROUND
Laparoscopic application of an adjustable gastric band (LAGB) is considered the least invasive surgical option for morbid obesity. It has the advantage of being potentially reversible and can improve quality of life.


METHODS
Between April 1997 and January 2001, 400 patients underwent LAGB. There were 352 women and 48 men with mean age 40.2 years (16-66). Preoperative mean body weight was 119 kg (85-195) and mean body mass index (BMI) was 43.8 kg/m2 (35.1-65.8).


RESULTS
Mean operative time was 116 minutes (30-380), and mean hospital stay was 4.55 days (3-42). There was no death. There were 12 conversions (3%). 40 complications required an abdominal reoperation (10%), for perforation (n = 2), gastric necrosis (n = 1), slippage (n = 31), incisional hernia (n = 2) and reconnection of the tube (n = 4). We noticed 7 pulmonary complications (2 ARDS, 5 atelectasis) and 30 minor problems related to the access port. At 2 years, mean BMI had fallen from 43.8 to 32.7 kg/m2 and mean excess weight loss (EWL) was 52.7% (12-94).


CONCLUSIONS
LAGB is a very beneficial operation with an acceptable complication rate. EWL is 50% at 2 years if multidisciplinary follow-up remains assiduous. Surveillance for late anterior stomach slippage within the band is essential.
Chevallier
J M
JM
Dept. of Digestive & General Surgery, Hôpital Européen G. Pompidou, 20-40 rue Leblanc, 75908 Paris, France. jean-marc.chevallier@wanadoo.fr
Zinzindohoué
F
F
Elian
N
N
Cherrak
A
A
Blanche
J P
JP
Berta
J L
JL
Altman
J J
JJ
Cugnenc
P H
PH
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015391:Gastroplasty; D006779:Hospitals, Public; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome