Short- and long-term results of laparoscopic gastric banding for morbid obesity.
BACKGROUND
Today, gastric banding has become a common bariatric procedure. Weight loss can be excellent, but is not sufficient in a significant proportion of patients. Few long-term studies have been published. We present our results after up to 9 years of follow-up.


METHODS
One hundred twenty-seven patients (1997-2004) were analyzed retrospectively after laparoscopic gastric banding (perigastric technique: n = 60; pars flaccida technique: n = 67) in terms of preoperative characteristics, weight loss, comorbidities, short- and long-term complications, and quality of life.


RESULTS
Median follow-up was 63 months (range 2-104). Incidence of postoperative complications were: gastric perforation in 3.1%, band erosion in 3.1%, band or port leak in 2.3%, port infection in 5.3%, port dislocation in 6.9%, and pouch dilatation in 16.9%. Total number of patients requiring reoperation was 34 (26.7%) [perigastric technique n = 23 (38.8%) versus pars flaccida technique n = 11 (16%), p = 0.039]. Mean excess body weight loss (%) was 50.6%. Most patients reported an increase in quality of life after surgery.


CONCLUSIONS
Gastric banding is effective for achieving weight loss and improving comorbidity in obese patients. Obviously, gastric banding can be performed more safely with the pars flaccida technique, although the complication rate remains relatively high. Nevertheless, based on adequate patient selection, gastric banding should still be considered a valuable therapeutic option in bariatric surgery.
Bueter
Marco
M
Department of Surgery I, Julius-Maximillians-University of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany. bueter_m@chirurgie.uni-wuerzburg.de
Maroske
Joern
J
Thalheimer
Andreas
A
Gasser
Martin
M
Stingl
Theresa
T
Heimbucher
Johannes
J
Meyer
Detlef
D
Fuchs
Karl-Hermann
KH
Fein
Martin
M
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000523:psychology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology* / Q000523:psychology / Q000601:surgery; D011788:Quality of Life / Q000523:psychology; D012086:Reoperation; D015430:Weight Gain; D015431:Weight Loss; D055815:Young Adult