Results after laparoscopic adjustable gastric banding in patients over 55 years of age.
BACKGROUND
Laparoscopic adjustable gastric banding (LAGB) has become the most popular bariatric intervention in Europe. International guidelines recommended age limits for bariatric surgery of 18-60 years. The aim of this study was to evaluate the immediate results in morbidly obese patients >55 years old, treated with LAGB.


METHODS
Between January 1996 and January 2004, 350 patients underwent LAGB. 24 (6.8%) were >55 years old (Group A), mean age 58.6+/-3.3 years, mean preoperative BMI 42.3+/-4.5 kg/m2. A comparative randomized analysis with 24 patients younger than age 55 years was performed (Group B: mean age 41.2+/-9.6 years, mean BMI 42.1+/-3.6 kg/m2). Baseline clinical features, operative parameters and postoperative results were evaluated.


RESULTS
No perioperative complications were recorded. Conversion rate and mortality were nil. Major postoperative complications occurred in 2 patients (8.3%) from Group A (1 intragastric prosthesis migration, 1 pouch dilatation) and 2 patients (8.3%) from Group B (intragastric migrations). Reoperation was needed in 3 cases, and one erosion (Group B) is on the waiting list for removal. Minor complications: 1 port infection in each group required ambulatory port substitution; 1 intraperitoneal portcatheter disconnection (Group B) was successfully treated laparoscopically. Mean follow-up was 31.7 months (Group A) and 33.0 months (Group B). Mean postoperative BMI at 12 and 24 months was 35.9+/-4.2 and 33.8+/-4.9 for Group A, and 33.8+/-4.6 and 33.2+/-6.0 for Group B.


CONCLUSIONS
There have been no significant differences in results between the 2 groups. LAGB has been safe and effective in patients >55 years old.
Silecchia
Gianfranco
G
Department of General Surgery "Paride Stefanini", Rome, Italy. gianfranco.silecchia@uniroma1.it
Greco
Francesco
F
Bacci
Vincenzo
V
Boru
Cristian
C
Pecchia
Alessandro
A
Casella
Giovanni
G
Rizzello
Mario
M
Basso
Nicola
N
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002408:Catheters, Indwelling / Q000009:adverse effects; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications; D012086:Reoperation; D012449:Safety; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome