Injection port and connecting tube complications after laparoscopic adjustable gastric banding.
BACKGROUND
Port-site and connecting tube complications are usually considered minor problems in the follow-up of obese patients submitted to laparoscopic adjustable gastric banding (LAGB), but the incidence reported in literature ranges from 4.3% to 24%. These complications are mainly because of the mechanical stress of the port and the tube; therefore, their incidence might be time dependent and probably increase during the follow-up.


METHODS
We evaluated retrospectively 489 obese patients submitted to LAGB from February 1998 to December 2005, considering all the complications of the connecting tube and port. Their clinical signs, imaging exams, operative reports, and hospitalization files were evaluated.


RESULTS
The mean follow-up of the patients was 41 months. Seventy-one patients (14.5%) presented port and connecting tube complications that required 82 revisional operations. Fifty-four patients had system leaks, 3 had infection problems, and 14 mechanical problems, always requiring surgical revision. In five patients, the system leak was observed twice and required a second surgical repair, while one patient presented three times a leakage of the connecting tube and needed three surgical revisions. All cases of system leakage were related to significant weight regain. In one case of recurrent port infection, we had to remove the band.


CONCLUSIONS
Port-site and connecting tube problems are the most common complications after LAGB. Although they are considered marginal complications, they usually cause weight regain; their correction often requires surgical revision and sometimes removal of the band.
Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano, Universita' degli Studi di Milano, Milan, Italy. e.lattuada@policlinico.mi.it
Ezio
E
Lattuada
Marco Antonio
MA
Zappa
Enrico
E
Mozzi
Ilaria
I
Antonini
Paolo
P
Boati
Gian Carlo
GC
Roviaro
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D055815:Young Adult